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BOND DRUG COMPANY OF ILLINOIS, L.L.C.
DSH140088 THE UNIVERSITY OF CHICAGO MEDICAL CENTER
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Covered Entity Details
Entity Name
THE UNIVERSITY OF CHICAGO MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140088
Entity Address
5841 S. MARYLAND AVE.
CHICAGO, IL 60637
Medicare Provider Number
140088
Participating Start Date
10/1/2003
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
BOND DRUG COMPANY OF ILLINOIS, L.L.C.
Pharmacy Address
DBA: WALGREENS # 03779
100 LAKE ST
MAYWOOD, IL 60153
Pharmacy Comments
Pharmacy correction, changed in error on 3/28/2013, see history for details.
Contract Details
Approval Date
9/21/2012
Contract Begin Date
9/21/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Watson, Chief Financial Officer
(773) 834-2802
Contract Pharmacy Representative
Walgreens
Myles Sobczak, Lawyer
(847) 964-6589
Signed By Date
9/21/2012
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