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WALGREEN CO.
FQHCLA417 INFANT WELFARE SOCIETY OF CHICAGO
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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
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09024
5 WEST IRVING PARK ROAD
BENSENVILLE, IL 60106
Pharmacy Comments
Contract Details
Approval Date
10/6/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen Lynne Williams, Chief Financial Officer
(773) 782-5017
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/6/2021
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