Contract Pharmacy Details

BOND DRUG COMPANY OF ILLINOIS, L.L.C.
FQHCLA417 INFANT WELFARE SOCIETY OF CHICAGO

Covered Entity Details

Entity Name

INFANT WELFARE SOCIETY OF CHICAGO

Subdivision Name

IWS Family Health Logan Square

Type

Health Center Program Look-Alike

340B ID

FQHCLA417

Entity Address

3600 W FULLERTON AVE
CHICAGO, IL 60647-2319

Grant Number

LALCS40176

Participating Start Date

12/21/2020

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

BOND DRUG COMPANY OF ILLINOIS, L.L.C.

Pharmacy Address

DBA: WALGREENS # 03072
641 N CLARK ST
CHICAGO, IL 60654

Pharmacy Comments

Contract Details

Approval Date

12/30/2020

Contract Begin Date

12/31/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/6/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Karen Lynne Williams, Chief Financial Officer
(773) 782-5017

Contract Pharmacy Representative

Walgreens
Andrea Koper, 340B Client Relations
(847) 964-6077

Signed By Date

12/30/2020

340B Drug Pricing Program Database