Blue Medicare Advantage PPO Contracted Providers

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Appendix D Blue Medicare Advantage PPO Contracted Providers Ambulatory Surgicenters... 2 Durable Medical Equipment... 4 Hearing Aid 6 Home Health Care.. 7 Home Infusion 10 Hospice... 11 Inpatient Metro Hospitals 12 Mental Health 15 Orthotic & Prosthetic. 16 Hospital Based Outpatient Surgery 18 Renal Dialysis 20 Skilled Nursing Facilities.. 26 Rev.03/13/2018 Division of Healthcare Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER SURGICENTER 10/1/17 ADVANCED AMBULATORY SURG CTR INC 2333 N HARLEM AVE CHICAGO IL 60707-2718 (773) 637-1700 A 12/1/17 SURGICENTER 7/1/17 ADVOCATE SURGERY CTR LIBERTYVILLE 825 S MILWAUKEE AVE LIBERTYVILLE IL 60048-3218 (224) 504-2200 A 2/1/18 SURGICENTER 2/1/17 AIDEN CENTER FOR DAY SURGERY 1580 W LAKE ST ADDISON IL 60101-1171 (630) 285-7000 A 2/1/17 SURGICENTER 5/1/16 APOLLO SURGICAL CENTER LLC 2750 S RIVER RD DES PLAINES IL 60018-4103 (847) 385-0700 A 6/1/16 SURGICENTER 2/1/17 ASHTON SURGICAL CENTER 1800 MCDONOUGH RD HOFFMAN ESTATES IL 60192-4566 (847) 742-7272 A 2/1/17 SURGICENTER 11/1/17 ASSOCIATED SURGICAL CENTER LLC 129 W RAND RD ARLINGTON HEIGHTS IL 60004-3142 (847) 215-0530 A 2/1/18 SURGICENTER 9/1/16 CENTER FOR RECONSTRUCTIVE SURGERY 6311 W 95TH ST OAK LAWN IL 60453-2201 (708) 499-3355 A 10/1/16 SURGICENTER 6/1/16 CHICAGO PROSTATE CANCER SURG CTR 815 PASQUINELLI DR WESTMONT IL 60559-1276 (630) 654-2515 A 11/1/16 SURGICENTER 4/1/15 DUPAGE EYE SURGERY CENTER LLC 2015 N MAIN ST WHEATON IL 60187-3152 (630) 665-3690 SURGICENTER 2/1/16 ELMHURST OUTPATIENT SURGERY CTR 1200 S YORK RD ELMHURST IL 60126-5626 (630) 758-8800 SURGICENTER 10/1/16 EYE SURGERY CENTER OF HINSDALE 950 N YORK RD HINSDALE IL 60521-8609 (630) 789-6700 A 11/1/16 SURGICENTER 6/1/16 FULLERTON SURGERY CENTER 4849 W FULLERTON AVE CHICAGO IL 60639-2503 (773) 237-2900 A 6/1/16 SURGICENTER 5/1/15 GLEN ENDOSCOPY CENTER LLC 2551 COMPASS RD GLENVIEW IL 60026-8042 (800) 590-2713 SURGICENTER 10/1/15 GOLF SURGICAL CENTER 8901 GOLF RD DES PLAINES IL 60016-6850 (847) 299-2273 SURGICENTER 5/1/15 HOFFMAN ESTATES SURGERY CNTR LLC 1555 BARRINGTON RD HOFFMAN ESTATES IL 60169-1019 (847) 519-1600 SURGICENTER 1/1/18 IL SPORTS MED AND ORTHO SURG CTR 9000 WAUKEGAN RD MORTON GROVE IL 60053-2128 (847) 213-5444 A 2/1/18 SURGICENTER 8/1/16 KENDALL POINT SURGERY CNTR 100 W FIFTH ST OSWEGO IL 60543-8338 (630) 449-0085 A 10/1/16 SURGICENTER 1/1/17 LOYOLA AMBULATORY SURGERY CENTER 1S224 SUMMIT AVE OAKBROOK TERRACE IL 60181-3943 (630) 916-7088 A 2/1/17 SURGICENTER 7/1/15 MIDWEST CENTER FOR DAY SURGERY 3811 HIGHLAND AVE DOWNERS GROVE IL 60515-1555 (630) 852-9300 SURGICENTER 7/1/15 NAPERVILLE SURGICAL CENTRE LLC 1263 RICKERT DR NAPERVILLE IL 60540-0954 (630) 305-3300 SURGICENTER 1/1/15 NORTHWEST COMM DAY SURG CTR II 675 W KIRCHHOFF RD ARLINGTON HEIGHTS IL 60005-2371 (847) 618-7060 SURGICENTER 1/1/17 NORTHWEST SURGICARE LTD 1100 W CENTRAL RD ARLINGTON HEIGHTS IL 60005-2402 (847) 259-3080 A 2/1/17 SURGICENTER 9/1/16 NOVA MED SURGERY OF CHICAGO 3034 W PETERSON AVE CHICAGO IL 60659-3729 (773) 973-7432 A 10/1/16 SURGICENTER 2/1/17 OAK BROOK SURGICAL CENTER 2425 W 22ND ST OAK BROOK IL 60523-1245 (630) 990-2212 A 2/1/17 SURGICENTER 5/1/15 OAK LAWN ENDOSCOPY 9921 SOUTHWEST HIGHWAY OAK LAWN IL 60453-3754 (708) 499-5678 SURGICENTER 7/1/15 PALOS HILLS SURGERY CENTER LLC 10330 S ROBERTS RD PALOS HILLS IL 60465-1999 (708) 237-7290 SURGICENTER 10/1/15 PALOS SURGI CENTER LLC 7340 COLLEGE DR PALOS HEIGHTS IL 60463-1159 (708) 361-3233 SURGICENTER 5/1/16 RAVINE WAY SURGERY CENTER LLC 2350 RAVINE WAY GLENVIEW IL 60025-7657 (847) 832-1555 A 10/1/16 SURGICENTER 1/1/17 RUSH COPLEY SURGICENTER LLC 2111 OGDEN AVENUE AURORA IL 60504-7597 (630) 978-3800 A SURGICENTER 10/1/16 SOUTHWEST SURGERY CENTER LLC CNTR 19110 DARVIN DR MOKENA IL 60448-8595 (708) 478-8889 SURGICENTER 8/1/16 SOUTHWESTERN MEDICAL CTR LLC 7456 S STATE ROAD BEDFORD PARK IL 60638-6621 (773) 445-9696 A 10/1/16 SURGICENTER 1/1/17 THE CENTER FOR SURGERY 475 E DIEHL RD NAPERVILLE IL 60563-1353 (630) 505-7733 A 2/1/17 SURGICENTER 5/1/15 THE LAKE BLUFF IL ENDOSCOPY ASC 101 S WAUKEGAN RD LAKE BLUFF IL 60044-3013 (847) 604-8700 SURGICENTER 7/1/15 TINLEY WOODS SURGERY CENTER 18200 S LAGRANGE RD TINLEY PARK IL 60487-7721 (708) 570-2490 SURGICENTER 8/1/15 TRI CITIES SURGERY CENTER LLC 345 DELNOR DR GENEVA IL 60134-4220 (630) 262-8100 SURGICENTER 5/1/16 UNITED SHOCKWAVE SERVICES LTD 120 N LAGRANGE RD LAGRANGE IL 60525-2040 (708) 352-6666 A 8/1/16 SURGICENTER 8/1/16 VALLEY AMBULATORY SURGERY CENTER 2210 DEAN ST ST CHARLES IL 60175-1066 (630) 584-9800 A 9/1/16 SURGICENTER 10/1/17 WINCHESTER ENDOSCOPY 1870 W WINCHESTER RD LIBERTYVILLE IL 60048-5359 (224) 433-6505 A 11/1/17 s: A: New C: 2

Eff Organization Name Office Address 1 City State Zip PHONE NUMBER N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 3

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER DME 9/1/16 A TO Z MOBILITY AND MED EQUIP 23838 W INDUSTRIAL DR N PLAINFIELD IL 60585-8516 (779) 234-9072 DME 8/1/16 AAMS SUPPLY CHICAGO INC 6433 N CALIFORNIA AVE CHICAGO IL 60645-5208 (773) 764-0184 DME 8/1/16 AAMS SUPPLY CHICAGO INC 6433 N CALIFORNIA AVE CHICAGO IL 60645-5208 (773) 764-0184 A DME 1/1/14 APRIA HEALTHCARE INC 1015 W DEITWEILLER DR PEORIA IL 61615-2064 (309) 691-1012 DME 3/1/16 APRIA HEALTHCARE INC 1015 W DEITWEILLER DR PEORIA IL 61615-2064 (309) 691-1012 DME 8/1/15 ARMOR MED SUPPLY LLC CHCAGO SOUTH 16643 S KEDZIE MARKHAM IL 60428-5512 (708) 331-7111 DME 9/1/15 BASINGERS PHARMACY 2130 W JEFFERSON ST JOLIET IL 60435-6622 (815) 725-1102 DME 12/1/16 BLI MEDICAL SUPPLY LTD 7737 S WESTERN AVE CHICAGO IL 60620-5821 (773) 476-4400 A DME 1/1/14 BYRAM HEALTHCARE INC 3010 WOODCREEK DR DOWNERS GROVE IL 60515-5415 (800) 681-1395 DME 1/1/17 CENTEGRA HOME MEDICAL EQUIPMENT 213 N FRONT ST MCHENRY IL 60050-5501 (815) 759-4444 DME 5/1/16 COMPLIANT SLEEP SOLUTIONS CONVERG 7501 LEMONT RD WOODRIDGE IL 60517-2681 (630) 324-5370 A 6/1/16 DME 2/1/16 DJ O LLC 599 CARDIGAN RD SAINT PAUL MN 55126-3965 (800) 328-2536 DME 1/1/14 DOUBEK MEDICAL SUPPLY INC 11350 S CICERO AVE ALSIP IL 60803-2830 (708) 293-1122 DME 8/1/15 EMPI INC 599 CARDIGAN RD SAINT PAUL MN 55126-3965 (800) 328-2536 DME 8/1/15 FITZSIMMONS SURGICAL SUPPLY 8000 W 186TH ST TINLEY PARK IL 60487-9215 (708) 532-1199 DME 12/1/16 HAYAT HOME MEDICAL EQUIPMENT 3518 W 95TH ST EVERGREEN PARK IL 60805-2105 (708) 422-2300 A DME 9/1/15 HEALTH TECHNOLOGY RESOURCES 1400 E LAKE COOK RD BUFFALO GROVE IL 60089-8219 (847) 947-8044 DME 1/1/17 HEARTLAND HOME MEDICAL SUPPLY 716 E EMPIRE ST BLOOMINGTON IL 61701-8613 (309) 829-8122 DME 1/1/15 HOVEROUND CORPORATION 241 S FRONTAGE RD BURR RIDGE IL 60527-4400 (800) 701-5781 DME 9/1/15 ILLINOIS SLEEP PROVIDER 8736 W OGDEN AVE LYONS IL 60534-1060 (708) 442-9800 DME 1/1/17 INDEPENDENCE PLUS INC 720 ENTERPRISE DR OAK BROOK IL 60523-1908 (630) 463-4400 A 7/1/17 DME 6/1/16 INFUSYSTEM INC 350 S NORTHWEST HWY PARK RIDGE IL 60068-4216 (800) 962-9656 DME 6/1/16 INFUSYSTEM INC 600 JOHN DEERE RD MOLINE IL 61265-6812 (800) 962-9656 DME 3/1/16 LEHAN DRUG INC 1407 S 4TH ST DEKALB IL 60115-4605 (815) 758-0911 DME 1/1/14 LINCARE INC 1701 HOWARD ST ELK GROVE VILLAGE IL 60007-2483 (847) 806-8080 DME 1/1/14 LINCARE INC 700 N HENERIETTA ST EFFINGHAM IL 62401-1720 (217) 347-7002 DME 1/1/14 MARK DRUG 548A W DUNDEE RD WHEELING IL 60090-2608 (847) 537-8500 DME 3/1/17 MARS MEDICAL EQUIPMENT SUPPLY 333 W MAPLE ST NEW LENOX IL 60451-1633 (708) 425-1550 A 7/1/17 DME 8/1/15 MCKESSON PATIENT CARE SOLUTIONS 140 EXCHANGE BLVD GLENDALE HEIGHTS IL 60139-2089 (856) 273-9900 DME 1/1/17 MED SOURCE LLC 3002 GILL ST BLOOMINGTON IL 61704-3438 (309) 664-7930 DME 5/1/16 MEDLINE INDUSTRIES INC 1 MEDLINE PL MUNDELEIN IL 60060-4485 (866) 356-4997 A 8/1/16 DME 10/1/17 MEDSERV EQUIPMENT CORP 20066 N RAND RD PALATINE IL 60074-2030 (847) 359-4607 A 2/1/18 DME 1/1/17 MEDSOURCE LLC 700 N SACRAMENTO BLVD CHICAGO IL 60612-1046 (888) 510-5100 A DME 8/1/15 MERIT SLEEP TECHNOLOGIES INC 1300 S MAIN ST LOMBARD IL 60148-4526 (630) 652-7900 DME 5/1/15 MINI MED DIST CORP 3725 25TH AVE SCHILLER PARK IL 60176-2147 (800) 341-3849 DME 1/1/15 MOBILITY SYSTEMS SOLUTIONS INC 9755 S 78TH AVE HICKORY HILLS IL 60457-2301 (708) 599-3500 DME 2/1/15 NATIONAL SEATING AND MOBILITY INC 11551 S RIDGELAND AVE ALSIP IL 60803-2409 (708) 361-7060 DME 2/1/15 NATIONAL SEATING AND MOBILITY INC 4209 PFIEFFER RD BARTONVILLE IL 61607-2812 (866) 740-3252 DME 1/1/17 NATIONAL SEATING AND MOBILITY INC 10055 S 76TH AVENUE BRIDGEVIEW IL 60455-2443 (844) 774-8348 A DME 2/1/15 NATIONAL SEATING AND MOBILITY INC 3808 W SPRINGFIELD AVE CHAMPAIGN IL 61822-8806 (217) 355-1399 DME 2/1/15 NATIONAL SEATING AND MOBILITY INC 85 EISENHOWER LN SOUTH LOMBARD IL 60148-5409 (630) 495-3751 DME 8/1/17 NATIONWIDE MEDICAL EQUIPMENT 3301 W 63RD ST CHICAGO IL 60629-3316 (773) 434-3780 A 12/1/17 DME 8/1/16 OPTION HEALTH LTD 985 AVE OF THE CITIES SILVIS IL 61282-7001 (309) 792-7200 A 9/1/16 DME 1/1/16 ORBIT MED OF NAPERVILLE INC 1701 QUINCY AVE NAPERVILLE IL 60540-3955 (630) 544-5381 DME 1/1/16 ORBIT MEDICAL OF CHICAGO INC 1419 W CARROLL AVE CHICAGO IL 60607-1105 (866) 565-2375 DME 12/1/15 ORTHOFIX INC 875 N MICHIGAN AVE CHICAGO IL 60611-1962 (800) 527-0404 4

Eff Organization Name Office Address 1 City State Zip PHONE NUMBER DME 11/1/17 OTTO BOCK ORTHOPEDIC SERVICES LLC 467 W FULLERTON AVE ELMHURST IL 60126-1404 (800) 736-8276 A DME 6/1/16 PACIFIC PULMONARY SERVICES 2201 W TOWNLINE RD PEORIA IL 61615-1565 (309) 693-0375 A 8/1/16 DME 6/1/16 PACIFIC PULMONARY SERVICES 3384 N PUBLISHERS ROCKFORD IL 61109-6334 (815) 874-1314 A 8/1/16 DME 6/1/16 PACIFIC PULMONARY SERVICES 9935 S 76TH AVE BRIDGEVIEW IL 60455-2452 (708) 599-7339 A 8/1/16 DME 6/1/16 PACIFIC PULMONARY SERVICES 4511 N KEDZIE AVE CHICAGO IL 60625-4510 (773) 477-8802 A 8/1/16 DME 6/1/16 PACIFIC PULMONARY SERVICES 1521 WRIGHT BLVD SCHAUMBURG IL 60193-4509 (847) 895-4834 A 8/1/16 DME 6/1/16 PACIFIC PULMONARY SERVICES 1551 E 91ST DR MERRILLVILLE IN 46410-7177 (219) 736-5828 A 8/1/16 DME 2/1/15 PATIENTS CHOICE 625 W UNIVERSITY DR ARLINGTON HEIGHTS IL 60004-1826 (847) 818-9088 DME 1/1/16 PREMIER MEDICAL PRODUCTS INC 1701 QUINCY AVE NAPERVILLE IL 60540-6689 (630) 420-0308 DME 1/1/14 REHABTECH SUPPLY CORPORATION 655 W GRAND AVE ELMHURST IL 60126-1061 (888) 800-9445 DME 1/1/14 RGH ENTERPRISES INC DBA EDGEPARK 1360 MADELINE LN ELGIN IL 60124-8835 (800) 307-5930 DME 1/1/17 RIVERSIDE HEALTH EQUIPMENT 44 MEADOWVIEW CENTER KANKAKEE IL 60901-2041 (815) 935-7508 A 9/1/17 DME 8/1/16 SIGMA SURGICAL SUPPLY CORP 2708 W DIVISION CHICAGO IL 60622-2853 (773) 235-5553 DME 5/1/16 SIONA HEALTH CARE PRODUCTS INC 5011 N LINCOLN AVE CHICAGO IL 60625-2611 (773) 907-0680 A 6/1/16 DME 1/1/15 SLEEP RX LLC 7536 N ST LOUIS SKOKIE IL 60076-4034 (847) 676-4138 DME 8/1/15 SLEEPMED THERAPIES INC 2357 HASSELL ROAD HOFFMAN ESTATES IL 60169-2172 (847) 490-9309 DME 8/22/16 THH ACQUISITION LLC I 1701 N RANDALL ROAD ELGIN IL 60123-7820 (847) 931-9300 A 11/1/16 DME 5/1/15 THH ACQUISITION LLC I 780 S MCLEAN BLVD ELGIN IL 60123-6710 (847) 931-9300 DME 1/1/14 UNITED SEATING AND MOBILITY LLC 335 EISENHOWER LN S LOMBARD IL 60148-5406 (630) 424-0330 DME 1/1/15 WALGREEN MEDICAL SUPPLY LLC 18861 90TH AVE MOKENA IL 60448-8036 (888) 410-5779 DME 1/1/15 WALGREENS HOME CARE INC 4721 135TH ST CRESTWOOD IL 60445-1404 (800) 323-2828 DME 9/1/15 WOUND CARE SOLUTIONS INC 2003 W FULTON ST CHICAGO IL 60612-2345 (312) 738-2330 DME 2/1/17 ZOLL SERVICES LLC 121 GAMMA DR PITTSBURGH PA 15238-2919 (800) 543-3267 A s: A: New C: N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 5

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER HEARING AID SUPPLIER 8/1/16 COCHLEAR AMERICAS 13059 E PEAKVIEW AVE CENTENNIAL CO 80111-6511 (800) 633-4667 A 4/1/17 HEARING AID SUPPLIER 1/1/15 TRU HEARING INC 12936 FRONTRUNNER BOULEVARD DRAPER UT 84020 (844) 285-9917 A 2/1/18 HEARING AID SUPPLIER 1/1/15 TRU HEARING INC 1901 N ROSELLE RD SCHAUMBURG IL 60195-3186 (773) 677-8783 A s: A: New C: N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 6

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER HOME HEALTH CARE 11/1/16 1ST FAMILY HOME HEALTHCARE INC 666 RUSSEL CT WOODSTOCK IL 60098-2672 (815) 337-4240 HOME HEALTH CARE 9/1/15 A 2 Z HEALTHCARE SERVICE LLC 15347 70TH CT ORLAND PARK IL 60462-5156 (708) 332-9070 HOME HEALTH CARE 3/1/15 ABCOR HOME HEALTH INC 3201 N WILKE RD ARLINGTON HEIGHTS IL 60004-1437 (847) 670-8424 HOME HEALTH CARE 4/1/16 ACE HEALTH CARE SERVICES LLC 4731 W MIDLOTHIAN TURNPIKE CRESTWOOD IL 60445-1990 (708) 926-9137 HOME HEALTH CARE 4/1/16 ADDUS HEALTHCARE 20280 GOVERNORS HWY OLYMPIA FIELDS IL 60461-1076 (708) 283-4240 HOME HEALTH CARE 9/1/16 ADVANCE HOME HEALTH INC 800 ROOSEVELT RD GLEN ELLYN IL 60137-5847 (630) 545-0179 A 11/1/16 HOME HEALTH CARE 7/1/16 ADVANTAGE HOME HEALTH CARE INC 425 E US ROUTE 6 MORRIS IL 60450-9042 (815) 467-1905 A 8/1/16 HOME HEALTH CARE 3/1/17 ADVENTIST HEALTH CARE AT HOME 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525-2600 (708) 245-6901 A 4/1/17 HOME HEALTH CARE 3/1/16 ALC HOME HEALTH CARE INC 477 E BUTTERFIELD RD LOMBARD IL 60148-4881 (630) 368-1102 A 6/1/16 HOME HEALTH CARE 3/1/15 ALEXIAN BROTHERS HOME HEALTH AGE 1515 E LAKE ST HANOVER PARK IL 60133-7152 (847) 437-5500 HOME HEALTH CARE 2/1/16 ALL FAMILY HEALTH CARE INC 6413 N KINZUA AVE CHICAGO IL 60646-2853 (773) 775-2588 HOME HEALTH CARE 1/1/15 ALL QUALITY HOME HEALTH CARE LLC 395 E DUNDEE RD WHEELING IL 60090-7017 (224) 676-1470 HOME HEALTH CARE 3/1/15 AMEDISYS HOME HEALTH 765 ELA RD LAKE ZURICH IL 60047-2339 (847) 643-8480 HOME HEALTH CARE 3/1/15 AMEDISYS ILLINOIS OF TINLEY PARK 18450 CROSSING DR TINLEY PARK IL 60487-9279 (708) 532-3324 HOME HEALTH CARE 2/1/16 AMERICHOICE HEALTH CARE INC 950 SKOKIE BLVD NORTHBROOK IL 60062-4018 (847) 714-9787 HOME HEALTH CARE 5/1/15 ANGEL HEALTH CARE LLC 2625 BUTTERFIELD RD OAK BROOK IL 60523-1275 (847) 510-5905 HOME HEALTH CARE 8/1/16 ANREX HEALTHCARE INC 6200 N HIAWATHA CHICAGO IL 60646-4314 (773) 285-1000 A 9/1/16 HOME HEALTH CARE 8/1/16 ASPIRE HOME HEALTHCARE LLC 8930 WAUKEGAN RD MORTON GROVE IL 60053 (312) 788-8014 A 10/1/16 HOME HEALTH CARE 3/1/16 AT HOME HEALTH INC 3344 W PETERSON AVE CHICAGO IL 60659-3533 (773) 279-9244 HOME HEALTH CARE 3/1/15 ATNT HOME HEALTH CARE INC 10719 WINTERSET DR ORLAND PARK IL 60467-1106 (708) 364-7298 HOME HEALTH CARE 2/1/16 AUXILIUM HEALTHCARE SERVICES 129 FAIRFIELD WAY BLOOMINGDALE IL 60108-1557 (224) 765-0100 HOME HEALTH CARE 9/1/15 AWESOME HOME HEALTH CARE 10540 S WESTERN AVE CHICAGO IL 60643-2540 (773) 840-3386 HOME HEALTH CARE 8/1/17 BETTER CARE HOME HEALTH INC 2860 S RIVER RD DES PLAINES IL 60018-6009 (847) 758-1773 A HOME HEALTH CARE 3/1/16 BETTER CHOICE HOME HEALTH INC 7250 N CICERO AVE LINCOLNWOOD IL 60712-1643 (847) 677-7000 HOME HEALTH CARE 4/1/16 BG HOME HEALTH PROVIDERS LLC 133 W RAND ROAD ARLINGTON HEIGHTS IL 60004-3142 (847) 656-5035 HOME HEALTH CARE 1/1/17 BOWES IN HOME CARE INC 906 IL ROUTE 22 FOX RIVER GROVE IL 60021-1905 (847) 742-5757 HOME HEALTH CARE 1/1/17 CARE IN THE HOME HEALTH SERVS 1200 CENTRAL AVE WILMETTE IL 60091-2654 (847) 256-1705 A 3/1/17 HOME HEALTH CARE 6/1/16 CARELINK HOME HEALTH LLC 33 W HIGGINS RD SOUTH BARRINGTON IL 60010-9121 (847) 426-0300 A 6/1/16 HOME HEALTH CARE 7/1/16 CARESS HOME HEALTH CARE INC 3917 HOWARD STREET SKOKIE IL 60076-3778 (847) 674-7102 A 9/1/16 HOME HEALTH CARE 1/1/17 CENTEGRA HOME HEALTH CARE 4201 W MEDICAL CENTER DR MCHENRY IL 60050-8409 (815) 344-6602 HOME HEALTH CARE 5/1/16 CHICAGOLAND HOME HLTH PROV INC 2604 DEMPSTER ST PARK RIDGE IL 60068-8429 (847) 296-3950 A 6/1/16 HOME HEALTH CARE 8/1/15 CHOICECARE HOME HEALTH INC 6400 W COLLEGE DR PALOS HTS IL 60463-1789 (708) 489-0123 HOME HEALTH CARE 10/1/17 CLIENT HOME HEALTHCARE INC 9705 SOUTHWEST HIGHWAY OAK LAWN IL 60453-3685 (708) 529-2000 A 12/1/17 HOME HEALTH CARE 3/1/15 COMPLETE HOME HEALTH SERVICES INC 16234 PRINCE DR SOUTH HOLLAND IL 60473-3233 (708) 333-1700 HOME HEALTH CARE 9/1/17 CORNERSTONE HOME HEALTHCARE LLC 2800 S RIVER RD DES PLAINES IL 60018-6004 (847) 813-5641 A 9/1/17 HOME HEALTH CARE 1/1/17 COVENANTCARE AT HOME 3755 E MAIN ST ST CHARLES IL 60174-2409 (630) 845-0680 A 2/1/17 HOME HEALTH CARE 6/1/17 CRYSTAL HOME HEALTH CARE LLC 2720 S RIVER RD DES PLAINES IL 60018-4109 (847) 257-7620 A HOME HEALTH CARE 6/1/15 DIRECT HOME HEALTHCARE INC 4001 W DEVON AVE CHICAGO IL 60646-4538 (773) 777-9271 HOME HEALTH CARE 3/1/15 DIVINE INTERVENTION HLTHCARE INC 4747 LINCOLN MALL DR MATTESON IL 60443-3817 (708) 248-7662 HOME HEALTH CARE 9/1/17 ELITE HOME HEALTHCARE SOLUTIONS 707 SKOKIE BLVD NORTHBROOK IL 60062-2841 (847) 242-9786 A 9/1/17 HOME HEALTH CARE 11/1/16 ENTERA HEALTHCARE LTD 3349 MAIN ST SKOKIE IL 60076-2432 (847) 324-5550 HOME HEALTH CARE 6/1/16 EVERGREEN HOME HEALTHCARE 6069 DEMPSTER ST MORTON GROVE IL 60053-2943 (847) 583-8998 A 8/1/16 HOME HEALTH CARE 4/1/15 FAMILY HOME HEALTH SERVICES INC 2171 EXECUTIVE DR ADDISON IL 60101-5610 (630) 317-3300 HOME HEALTH CARE 5/1/17 FIRST CARE HEALTHCARE INC 924 CLOCK TOWER DRIVE SPRINGFIELD IL 62704-6031 (217) 718-4889 A HOME HEALTH CARE 8/1/15 FIRST HOME HEALTH CARE SERVICES 14730 KILBOURN MIDLOTHIAN IL 60445-3392 (708) 535-8609 HOME HEALTH CARE 3/1/17 FORUM HEALTHCARE 900 SKOKIE BLVD NORTHBROOK IL 60062-4031 (847) 897-9090 A 3/1/17 7

Eff Organization Name Office Address 1 City State Zip PHONE NUMBER HOME HEALTH CARE 11/1/15 GENTLE PRO HOME HEALTH CARE INC 2060 E ALGONQUIN RD SCHAUMBURG IL 60173-4162 (847) 593-3750 HOME HEALTH CARE 3/1/17 GIRLING HEALTHCARE INC 7222 W CERMAK RD NORTH RIVERSIDE IL 60546-1423 (708) 442-6420 A HOME HEALTH CARE 1/1/17 GOODHOPE HEALTHCARE AND HOME 3631 MUNICIPAL DR MCHENRY IL 60050-5434 (815) 344-9268 HOME HEALTH CARE 11/1/15 GOVVAS HEALTHCARE SERVICES INC 670 N 1ST BANK DR PALATINE IL 60067-8112 (847) 496-4715 HOME HEALTH CARE 4/1/17 GUARDIAN ANGEL HOME CARE INC 1420 RENAISSANCE DR PARK RIDGE IL 60068 (847) 674-2711 A HOME HEALTH CARE 2/1/15 GUARDIAN HOME HEALTH CARE LLC 181 WAUKEGAN RD NORTHFIELD IL 60093-2700 (847) 441-5020 HOME HEALTH CARE 5/1/15 HANDS OF WELLNESS INC 1062 SIBLEY BLVD CALUMET CITY IL 60409-2413 (708) 832-2228 HOME HEALTH CARE 10/1/17 HEALTH RESOURCE SOLUTIONS 1806 S HIGHLAND AVE LOMBARD IL 60148-4938 (312) 604-3740 A 11/1/17 HOME HEALTH CARE 12/1/16 HEALTHCARE PLUS CORPORATION 1272 N N W HWY PALATINE IL 60067 (847) 776-0800 A 1/1/17 HOME HEALTH CARE 6/1/15 HEALTHTRENDS LTD 200 E HOWARD AVE DES PLAINES IL 60018-5909 (847) 803-0774 HOME HEALTH CARE 2/1/18 HOLISTIC HEALTH PARTNERS INC 7021 W 153RD STREET ORLAND PARK IL 60462-5397 (708) 272-9398 A HOME HEALTH CARE 9/1/15 HOME CARE LIT CO OF MARY HOSP 2800 W 95TH ST EVERGREEN PARK IL 60805-2701 (708) 229-4663 HOME HEALTH CARE 8/1/16 HOME HEALTH ADVANTAGE INC 6120 N MILWAUKEE AVE CHICAGO IL 60646-3805 (773) 774-7700 A 10/1/16 HOME HEALTH CARE 7/1/16 HOME HEALTH CHOICE INC 8308 N LINCOLN AVE SKOKIE IL 60077-2436 (847) 568-0900 A 8/1/16 HOME HEALTH CARE 5/1/17 HOME HEALTH OF ILLINOIS LLC 5061 N PULASKI RD CHICAGO IL 60630-2706 (773) 509-1355 A HOME HEALTH CARE 11/1/16 HOME LIFE HEALTHCARE CORP 1020 W GOLF RD HOFFMAN ESTATES IL 60169 (847) 413-1611 HOME HEALTH CARE 2/1/17 INDEPENDENCE PLUS INC 720 ENTERPRISE DR OAK BROOK IL 60523-1908 (630) 463-4455 A 2/1/17 HOME HEALTH CARE 3/1/17 INGALLS HOME CARE 1 INGALLS DR HARVEY IL 60426-3558 (708) 331-0226 A HOME HEALTH CARE 2/1/16 INTEGRATED HOME HEALTHCARE SRVCS 900 TECHNOLOGY WAY LIBERTYVILLE IL 60048 (847) 549-0588 HOME HEALTH CARE 1/1/14 INTERIM HEALTHCARE 10735 S CICERO OAK LAWN IL 60453-6210 (708) 422-2934 HOME HEALTH CARE 4/1/17 JN FAMILY HOME HEALTHCARE 8750 W BRYN MAWR AVE CHICAGO IL 60631-3545 (773) 654-1690 A HOME HEALTH CARE 2/1/15 KINDRED AT HOME CHICAGO HOME HLTH 7101 N CICERO AVE LINCOLNWOOD IL 60712-2112 (847) 972-1590 HOME HEALTH CARE 1/1/15 LEXINGTON HOME HEALTH CARE INC 1300 S MAIN STREET LOMBARD IL 60148-4526 (630) 748-3700 HOME HEALTH CARE 9/1/16 LIFE CARE HOME HEALTH SERVICES 2255 MONARCH DR NAPERVILLE IL 60563-4164 (630) 300-1152 A 11/1/16 HOME HEALTH CARE 6/1/15 LIFECARE HOME HLTH SERVICES INC 3400 DUNDEE RD NORTHBROOK IL 60062-2365 (847) 205-4444 HOME HEALTH CARE 2/1/18 MEDI LINK HEALTH SERVICES LLC 1701 E WOODFIELD RD SCHAUMBURG IL 60173-5129 (847) 995-9900 A HOME HEALTH CARE 10/1/15 MIRANDA HOME HEALTHCARE 19150 S KEDZIE AVE FLOSSMOOR IL 60422 (708) 922-3710 HOME HEALTH CARE 1/1/15 NORTHWEST COMM HOSP HOME CARE 3060 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005-5027 (847) 618-1000 HOME HEALTH CARE 1/1/17 NORTHWEST HOME HEALTH AND REHAB 9249 S RTE 31 LAKE IN THE HILLS IL 60156 (847) 854-0186 HOME HEALTH CARE 4/1/16 NORTHWESTERN ILLINOIS HOME HEALTH 151 TENNEY ST KEWANEE IL 61443-3447 (309) 623-4022 HOME HEALTH CARE 1/1/14 NORTHWESTERN MED HOME HLTH HOSPIC 690 E NORTH AVE CAROL STREAM IL 60188-2172 (630) 665-7000 HOME HEALTH CARE 1/1/17 NOVA HOME HEALTHCARE INC 6900 MAIN ST DOWNERS GROVE IL 60516-3456 (630) 964-1222 A 2/1/17 HOME HEALTH CARE 1/1/15 O AND P HOME HEALTH CARE INC 4950 MAIN ST SKOKIE IL 60077-5205 (847) 329-7050 HOME HEALTH CARE 4/1/17 OPTION CARE ENTERPRISES INC 1226 MICHAEL DR WOOD DALE IL 60191-1056 (800) 551-9355 A HOME HEALTH CARE 4/1/17 OPTION CARE ENTERPRISES INC 2050 S FINLEY RD LOMBARD IL 60148-4837 (630) 495-2777 A HOME HEALTH CARE 10/1/15 PALOS COMMUNITY HOSP HOME HEALTH 15295 E 127TH ST LEMONT IL 60439-8410 (630) 257-1111 HOME HEALTH CARE 1/1/15 PEAK HOME HLTHC DBA NEWSOME HOME 920 ESSINGTON RD JOLIET IL 60435-2859 (815) 744-4770 HOME HEALTH CARE 1/1/17 PF DEVELOPMENT 5 LLC 4430 MANCHESTER DR ROCKFORD IL 61109-8316 (815) 397-8930 A 2/1/17 HOME HEALTH CARE 1/1/17 PF DEVELOPMENT 5 LLC 2401 W US HWY 20 PINGREE GROVE IL 60140-8819 (847) 683-9090 A 2/1/17 HOME HEALTH CARE 9/1/15 PHOENIX HOME CARE LLC 200 S FRONTAGE RD BURR RIDGE IL 60527-6953 (630) 321-9400 HOME HEALTH CARE 9/1/15 PREMIER POINT HOME HEALTH NFP 4701 N SHERIDAN RD CHICAGO IL 60640-5021 (773) 275-8390 HOME HEALTH CARE 1/1/14 PRIVATE HOME CARE UNLIMITED 5517 N CUMBERLAND CHICAGO IL 60656-4740 (773) 467-6000 HOME HEALTH CARE 10/1/17 PROVIDENCE AT HOME HEALTHCARE 18601 NORTH CREEK DR TINLEY PARK IL 60477 (800) 509-2800 A 9/1/17 HOME HEALTH CARE 6/1/16 PRUDENT CHOICE HOME HLTH CARE COR 1699 E WOODFIELD RD SCHAUMBURG IL 60173-4958 (847) 972-1028 A 8/1/16 HOME HEALTH CARE 11/1/16 RELIANCE HOME HEALTH CARE INC 3701 ALGONQUIN RD ROLLING MEADOWS IL 60008-3117 (847) 330-1406 HOME HEALTH CARE 8/1/16 RESILIENCE HOME HEALTH CORP 31 KENDALL POINT DR OSWEGO IL 60543 (630) 236-8800 A 9/1/16 HOME HEALTH CARE 1/1/17 RMC HOME HEALTH CARE 611 DIVISION ST PEOTONE IL 60468 (815) 935-3272 A 7/1/17 HOME HEALTH CARE 9/1/17 SENIOR CARE AT HOME INC 7021 W 153RD ST ORLAND PARK IL 60462-5397 (708) 687-3333 A 9/1/17 8

Eff Organization Name Office Address 1 City State Zip PHONE NUMBER HOME HEALTH CARE 7/1/16 SERENITY HOME HEALTHCARE 6677 N LINCOLN AVE LINCOLNWOOD IL 60712-3634 (773) 588-4000 A 8/1/16 HOME HEALTH CARE 6/1/15 SHAY HEALTHCARE SERVICES 5730 W 159TH ST OAK FOREST IL 60452-3163 (708) 535-4300 HOME HEALTH CARE 1/1/15 SILVER CROSS HOME HEALTH 1900 SILVER CROSS BLVD NEW LENOX IL 60451-9509 (815) 300-1100 HOME HEALTH CARE 3/1/16 SOLARIS HOME HEALTHCARE INC 3330 DUNDEE RD NORTHBROOK IL 60062-2329 (847) 701-2243 HOME HEALTH CARE 5/1/15 STAR HOME HEALTH SERVICES INC 8130 1/2 SOUTH KEDZIE CHICAGO IL 60652-2605 (773) 498-8943 HOME HEALTH CARE 5/1/15 TOTAL HOME HEALTHCARE 4001 WEST DEVON CHICAGO IL 60646-4540 (773) 853-2641 HOME HEALTH CARE 1/1/15 URBAN HEALTH LLC 224 S MILWAUKEE AVE WHEELING IL 60090-5006 (312) 292-6397 HOME HEALTH CARE 1/1/15 VANGUARD HEALTH AND WELLNESS 1585 ELLINWOOD AVE DES PLAINES IL 60016-4510 (855) 438-2431 HOME HEALTH CARE 10/1/16 VITAL HOME HEALTH CARE 8051 W 186TH ST TINLEY PARK IL 60477-9342 (708) 342-7076 A 11/1/16 HOME HEALTH CARE 7/1/15 WHOLE LIFE HOME HEALTH 7501 N MILWAUKEE AVE NILES IL 60714-3610 (847) 588-2111 HOME HEALTH CARE 3/1/16 WOUND AND REHAB HM HLTH CARE INC 700 BUSSE HIGHWAY PARK RIDGE IL 60068-2402 (847) 692-6000 s: A: New C: N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 9

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER HOME INFUSION 8/1/16 BIOSCRIP INFUSION SERVICES 321 W LAKE ST ELMHURST IL 60126-1539 (630) 617-0034 A 7/1/17 HOME INFUSION 1/1/14 CENTRAL DUPAGE SPECIAL HLTH ASSOC 690 E NORTH AVE CAROL STREAM IL 60188-2172 (630) 933-7777 HOME INFUSION 6/1/16 IV SOLUTIONS LLC 420 LAKE COOK RD DEERFIELD IL 60015-4914 (847) 945-4444 A 6/1/16 HOME INFUSION 1/1/14 METRO INFECTIOUS DISEASE CONSULTS 901 MCCLINTOCK DR BURR RIDGE IL 60527-0872 (630) 654-4201 HOME INFUSION 1/1/15 OPTION CARE ENTERPRISE 1226 MICHAEL DR WOOD DALE IL 60191-1005 (800) 551-9355 A HOME INFUSION 1/1/15 OPTION CARE ENTERPRISES 2050 S FINLEY RD LOMBARD IL 60148-4837 (630) 495-2777 HOME INFUSION 8/1/16 OPTION HEALTH LTD 321 W LAKE ST ELMHURST IL 60126-1539 (630) 617-0034 A 9/1/16 HOME INFUSION 6/1/15 OPTION HEALTH LTD 985 AVE OF THE CITIES SILVIS IL 61282-7001 (309) 792-7200 HOME INFUSION 1/1/18 PHARMASCRIPT INC 5437 N BROADWAY ST CHICAGO IL 60640-1703 (773) 681-0965 A HOME INFUSION 1/1/17 RIVERSIDE HOME INFUSION 350 N WALL ST KANKAKEE IL 60901-2901 (815) 965-3272 A HOME INFUSION 3/21/17 RUSH UNIVERSITY MED CNTR 610 S MAPLE AVE OAK PARK IL 60304-1003 (708) 660-6200 A HOME INFUSION 8/1/15 RUSH UNIVERSITY MED CNTR 1725 W HARRISON ST CHICAGO IL 60612-3841 (312) 563-2093 HOME INFUSION 1/1/16 RX CONSULT INC DBA HEALTH OPTIONS 110 S MARKET ST SPARTA IL 62286-2062 (618) 443-1155 s: A: New C: N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 10

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER HOSPICE 4/1/16 ACCORD HOSPICE INC 1247 LYNN TERRACE HIGHLAND PARK IL 60035-1030 (847) 780-4594 HOSPICE 3/1/15 ALEXIAN BROTHERS HOSPICE 1515 E LAKE ST HANOVER PARK IL 60133-7152 (630) 233-5100 HOSPICE 1/1/15 CNS HOME HEALTH 690 E NORTH AVE CAROL STREAM IL 60188-2172 (630) 665-7000 HOSPICE 2/1/17 COMFORT HOSPICE AND PALLIATIVE 8750 W BRYN MAWR AVE CHICAGO IL 60631-3545 (847) 983-8257 A 3/1/17 HOSPICE 9/1/14 COVENANT HOME SERVICES 3755 E MAIN ST ST CHARLES IL 60174-2409 (630) 845-0680 HOSPICE 4/1/15 FAMILY CENTERED HOSPICE 2171 EXECUTIVE DR ADDISON IL 60101-5610 (630) 317-3300 HOSPICE 4/1/17 HARBOR LIGHT HOSPICE 800 ROOSEVELT RD GLEN ELLYN IL 60137-5839 (800) 419-0542 A 4/1/17 HOSPICE 4/1/17 HOPE PALLIATIVE AND HOSPICE CARE 1274 W NORTHWEST HWY PALATINE IL 60067-1897 (847) 803-0400 A 4/1/17 HOSPICE 7/1/15 HOSPICE ADVANTAGE 16W485 S FRONTAGE BURR RIDGE IL 60527-7155 (708) 499-3400 HOSPICE 3/1/16 HOSPICE OF GREATER CHICAGO LLC 1727 S INDIANA AVE CHICAGO IL 60616-1345 (630) 226-1306 HOSPICE 3/1/17 INGALLS HOME HOSPICE 1 INGALLS DR HARVEY IL 60426-3558 (708) 331-0226 A HOSPICE 2/1/16 INTEGRATED PALLIATIVE HOSPICE LLC 900 TECHNOLOGY WAY LIBERTYVILLE IL 60048-5364 (847) 549-0588 HOSPICE 1/1/15 LEXINGTON HOSPICE SERVICES LLC 1300 S MAIN STREET LOMBARD IL 60148-4526 (630) 652-7900 HOSPICE 9/1/15 LITTLE COMPANY OF MARY HOSPICE 9800 SOUTHWEST HWY OAK LAWN IL 60453-3617 (708) 422-6200 HOSPICE 10/1/15 PALOS COMMUNITY HOSPITAL HOSPICE 15295 E 127TH ST LEMONT IL 60439-8410 (630) 257-1111 HOSPICE 1/1/14 RAINBOW HOSPICE AND PALLIATIVE 1550 BISHOP CT MOUNT PROSPECT IL 60056-6039 (847) 685-9900 HOSPICE 8/1/15 RESIDENTIAL HOSPICE ILLINOIS 1431 OPUS PLACE DOWNERS GROVE IL 60515-1391 (855) 902-5100 HOSPICE 5/1/17 SOLACE HOSPICE & PALLIATIVE CARE 650 E DEVON AVE ITASCA IL 60143-1265 (847) 250-5036 A HOSPICE 3/1/17 ST THOMAS HOSPICE 119 E OGDEN AVE HINSDALE IL 60521-8654 (630) 856-6990 A HOSPICE 3/1/17 TRANSITIONS HOSPICE LLC 12040 RAYMOND CT HUNTLEY IL 60142-8069 (224) 267-0160 A 4/1/17 HOSPICE 1/1/17 1/1/17 TRANSITIONS HOSPICE LLC 12040 RAYMOND COURT HUNTLEY IL 60142-8069 (815) 637-2200 C 2/1/17 HOSPICE 1/1/14 VITAS INNOVATVE HOSPICE CARE CHGO 1340 S DAMEN AVE CHICAGO IL 60608-1170 (312) 997-7200 s: A: New C: N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 11

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER INPATIENT - METRO 1/1/14 ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440-4906 (630) 312-5000 INPATIENT - METRO 1/1/14 ADVENTIST BOLINGBROOK HOSPITAL 500 REMINGTON BLVD BOLINGBROOK IL 60440-4906 (630) 312-5000 INPATIENT - METRO 1/1/14 ADVENTIST GLEN OAKS HOSPITAL 701 WINTHROP AVE GLENDALE HEIGHTS IL 60139-1405 (630) 545-8000 INPATIENT - METRO 1/1/14 ADVENTIST HINSDALE HOSPITAL 120 N OAK ST HINSDALE IL 60521-3829 (630) 856-9000 INPATIENT - METRO 1/1/14 ADVENTIST LAGRANGE MEMORIAL HOSP 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525-2600 (708) 245-9000 INPATIENT - METRO 1/1/16 ADVOCATE BROMENN MEDICAL CTR 1304 FRANKLIN AVE NORMAL IL 61761-3558 (309) 454-1400 INPATIENT - METRO 1/1/14 ADVOCATE CHRIST HOSP MED CNTR 4440 W 95TH ST OAK LAWN IL 60453-2600 (708) 684-8000 INPATIENT - METRO 1/1/14 ADVOCATE CONDELL MEDICAL CENTER 801 S MILWAUKEE AVE LIBERTYVILLE IL 60048-3204 (847) 362-2900 INPATIENT - METRO 1/1/14 ADVOCATE GOOD SAMARITAN HOSPITAL 3815 HIGHLAND AVE DOWNERS GROVE IL 60515-1500 (630) 275-5900 INPATIENT - METRO 1/1/14 ADVOCATE GOOD SHEPHERD HOSPITAL 450 W HIGHWAY 22 BARRINGTON IL 60010-7509 (847) 381-9600 INPATIENT - METRO 1/1/14 ADVOCATE ILLINOIS MASONIC MED CNT 836 W WELLINGTON AVE CHICAGO IL 60657-5147 (773) 975-1600 INPATIENT - METRO 1/1/14 ADVOCATE LUTHERAN GENERAL HOSP 1775 DEMPSTER ST PARK RIDGE IL 60068-1143 (847) 723-2210 INPATIENT - METRO 1/1/14 ADVOCATE SHERMAN HOSPITAL 1425 N RANDALL RD ELGIN IL 60123 (847) 742-9800 INPATIENT - METRO 1/1/14 ADVOCATE SOUTH SUBURBAN HOSPITAL 17800 S KEDZIE AVE HAZEL CREST IL 60429-2029 (708) 799-8000 INPATIENT - METRO 1/1/14 ADVOCATE TRINITY HOSPITAL 2320 E 93RD ST CHICAGO IL 60617-3983 (773) 967-2000 INPATIENT - METRO 1/1/14 ALEXIAN BROTHERS BEHAVIORAL HLTH 1650 MOON LAKE BLVD HOFFMAN ESTATES IL 60194-1010 (847) 882-1600 INPATIENT - METRO 1/1/14 ALEXIAN BROTHERS MEDICAL CENTER 800 BIESTERFIELD RD ELK GROVE VILLAGE IL 60007-3361 (847) 437-5500 INPATIENT - METRO 11/1/17 AURORA CHICAGO LAKESHORE HOSP 4840 N MARINE DR CHICAGO IL 60640-7860 (773) 878-9700 A INPATIENT - METRO 1/1/17 CENTEGRA HOSPITAL MCHENRY 4201 W MEDICAL CENTER DR MCHENRY IL 60050-8409 (815) 344-5000 A 10/1/16 INPATIENT - METRO 1/1/17 CENTEGRA HOSPITAL WOODSTOCK 3701 DOTY RD WOODSTOCK IL 60098-7509 (815) 338-2500 A 10/1/16 INPATIENT - METRO 1/1/14 CENTRAL DUPAGE HOSPITAL 25 N WINFIELD RD WINFIELD IL 60190-1295 (630) 933-1600 INPATIENT - METRO 11/1/15 CHICAGO BEHAVIORAL HOSPITAL 555 WILSON RD DES PLAINES IL 60016-4729 (847) 768-5430 INPATIENT - METRO 1/1/15 COMMUNITY FIRST MEDICAL CENTER 5645 W ADDISON ST CHICAGO IL 60634-4403 (773) 282-7000 INPATIENT - METRO 1/1/14 COPLEY MEMORIAL HOSPITAL 2000 OGDEN AVE AURORA IL 60504-7222 (630) 978-6200 INPATIENT - METRO 1/1/14 DELNOR COMMUNITY HOSPITAL 300 RANDALL RD GENEVA IL 60134-4200 (630) 208-3000 INPATIENT - METRO 1/1/14 EDWARD HOSPITAL 801 S WASHINGTON ST NAPERVILLE IL 60540-7430 (630) 355-0450 INPATIENT - METRO 1/1/14 ELMHURST MEM HOSPITAL MAIN CAMPUS 155 E BRUSH HILL RD ELMHURST IL 60126-5658 (331) 221-1000 INPATIENT - METRO 1/1/17 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160-1612 (708) 681-3200 A 10/1/16 INPATIENT - METRO 1/1/18 HEARTLAND REGIONAL MEDICAL CTR 3333 W DE YOUNG MARION IL 62959-5884 (618) 998-7000 A INPATIENT - METRO 1/1/14 HOLY CROSS HOSPITAL 2701 W 68TH ST CHICAGO IL 60629-1813 (773) 884-9000 INPATIENT - METRO 1/1/15 INGALLS MEMORIAL HOSPITAL 1 INGALLS DR HARVEY IL 60426-3558 (708) 333-2300 INPATIENT - METRO 11/1/15 KINDRED CHGO CENTRAL HOSPITAL 4058 W MELROSE ST CHICAGO IL 60641-4799 (773) 736-7000 INPATIENT - METRO 11/1/15 KINDRED CHGO CENTRAL HOSPITAL 4058 W MELROSE ST CHICAGO IL 60641-4799 (773) 736-7000 INPATIENT - METRO 11/1/15 KINDRED HOSP NORTHLAKE 365 E NORTH AVE NORTHLAKE IL 60164-2628 (708) 345-8100 INPATIENT - METRO 11/1/15 KINDRED HOSP NORTHLAKE 365 E NORTH AVE NORTHLAKE IL 60164-2628 (708) 345-8100 INPATIENT - METRO 11/1/15 KINDRED HOSPITAL CHICAGO NORTH 2544 W MONTROSE CHICAGO IL 60618-1537 (773) 267-2622 A 10/1/16 INPATIENT - METRO 11/1/15 KINDRED HOSPITAL SYCAMORE 225 EDWARD ST SYCAMORE IL 60178-2137 (815) 895-2144 INPATIENT - METRO 1/1/14 KISHWAUKEE COMMUNITY HOSPITAL 1 KISH HOSPITAL DR DEKALB IL 60115 (815) 756-1521 INPATIENT - METRO 1/1/14 KISHWAUKEE COMMUNITY HOSPITAL 1 KISH HOSPITAL DR DEKALB IL 60115 (815) 756-1521 INPATIENT - METRO 1/1/14 LINDEN OAKS HOSPITAL 852 WEST ST NAPERVILLE IL 60540-6400 (630) 305-5500 INPATIENT - METRO 1/1/14 LITTLE COMPANY OF MARY HOSP 2800 W 95TH ST EVERGREEN PARK IL 60805-2701 (708) 422-6200 INPATIENT - METRO 1/1/17 LOYOLA UNIVERSITY MEDICAL CENTER 2160 S FIRST AVE MAYWOOD IL 60153-3328 (708) 216-9000 A 10/1/16 INPATIENT - METRO 1/1/14 MACNEAL HOSPITAL 3249 S OAK PARK AVE BERWYN IL 60402-3429 (708) 783-9100 INPATIENT - METRO 1/1/14 MARIANJOY REHABILITATION HOSPITAL 26 W 171 ROOSEVELT RD WHEATON IL 60187-6078 (630) 909-8000 INPATIENT - METRO 1/1/17 MERCY HOSPITAL AND MEDICAL CENTER 2525 S MICHIGAN AVE CHICAGO IL 60616-2333 (312) 567-2000 A 10/1/16 INPATIENT - METRO 12/1/16 METROSOUTH MEDICAL CENTER 12935 S GREGORY ST BLUE ISLAND IL 60406-2428 (708) 597-2000 12

Eff Organization Name Office Address 1 City State Zip PHONE NUMBER INPATIENT - METRO 1/1/14 MOUNT SINAI HOSPITAL 1500 S. CALIFORNIA CHICAGO IL 60608-1704 (773) 542-2000 INPATIENT - METRO 1/1/14 NORTHSHORE EVANSTON HOSPITAL 2650 RIDGE AVE EVANSTON IL 60201-1718 (847) 570-2000 INPATIENT - METRO 1/1/14 NORTHSHORE GLENBROOK HOSPITAL 2100 PFINGSTEN RD GLENVIEW IL 60026-1301 (847) 657-5800 INPATIENT - METRO 1/1/14 NORTHSHORE HIGHLAND PARK HOSPITAL 777 PARK AVE WEST HIGHLAND PARK IL 60035-2433 (847) 432-8000 INPATIENT - METRO 1/1/14 NORTHSHORE SKOKIE HOSPITAL 9600 GROSS POINT RD SKOKIE IL 60076-1214 (847) 677-9600 INPATIENT - METRO 1/1/14 NORTHWEST COMMUNITY HOSPITAL 800 W CENTRAL RD ARLINGTON HEIGHTS IL 60005-2349 (847) 618-1000 INPATIENT - METRO 1/1/17 NORTHWESTERN LAKE FOREST HOSPITAL 660 N WESTMORELAND RD LAKE FOREST IL 60045-1659 (847) 234-5600 A 7/1/17 INPATIENT - METRO 1/1/17 NORTHWESTERN MEMORIAL HOSPITAL 251 E HURON CHICAGO IL 60611-2908 (312) 926-2000 A 7/1/17 INPATIENT - METRO 1/1/14 PALOS COMMUNITY HOSPITAL 12251 S 80TH AVE PALOS HEIGHTS IL 60463-1256 (708) 923-4000 INPATIENT - METRO 1/1/14 PRESENCE COVENANT MEDICAL CENTER 1400 W PARK ST URBANA IL 61801-2334 (217) 337-2000 INPATIENT - METRO 1/1/14 PRESENCE HOLY FAMILY MEDICAL CTR 100 N RIVER RD DES PLAINES IL 60016-1209 (847) 297-1800 INPATIENT - METRO 1/1/14 PRESENCE MERCY MEDICAL CENTER 1325 N HIGHLAND AVE AURORA IL 60506-1449 (630) 859-2222 INPATIENT - METRO 1/1/14 PRESENCE RESURRECTION MED CTR 7435 W TALCOTT AVE CHICAGO IL 60631-3707 (773) 774-8000 INPATIENT - METRO 1/1/14 PRESENCE ST FRANCIS HOSPITAL 355 RIDGE AVE EVANSTON IL 60202-3328 (847) 316-4000 INPATIENT - METRO 1/1/14 PRESENCE ST JOSEPH HOSP CHICAGO 2900 N LAKE SHORE DR CHICAGO IL 60657-5640 (773) 665-3000 INPATIENT - METRO 1/1/14 PRESENCE ST JOSEPH HOSP CHICAGO 2900 N LAKE SHORE DR CHICAGO IL 60657-5640 (773) 665-3000 INPATIENT - METRO 1/1/14 PRESENCE ST JOSEPH HOSP ELGIN 77 N AIRLITE ST ELGIN IL 60123-4912 (847) 695-3200 INPATIENT - METRO 1/1/14 PRESENCE ST JOSEPH MEDICAL CTR 333 N MADISON ST JOLIET IL 60435-8200 (815) 725-7133 INPATIENT - METRO 1/1/14 PRESENCE ST MARY ELIZABETH MDCT 2233 W DIVISION ST CHICAGO IL 60622-3043 (312) 770-2000 INPATIENT - METRO 1/1/14 PRESENCE ST MARYS HOSPITAL 500 W COURT ST KANKAKEE IL 60901-3661 (815) 937-2490 INPATIENT - METRO 1/1/14 PRESENCE UNITED SAMARITANS MED CT 812 N LOGAN AVE DANVILLE IL 61832-3752 (217) 443-5000 INPATIENT - METRO 1/1/17 RIVERSIDE MEDICAL CENTER 350 N WALL ST KANKAKEE IL 60901-2901 (815) 933-1671 A 11/1/16 INPATIENT - METRO 1/1/14 RML SPECIALTY HOSPITAL 5601 S COUNTY LINE RD HINSDALE IL 60521-4875 (630) 286-4223 INPATIENT - METRO 1/1/14 RML SPECIALTY HOSPITAL 5601 S COUNTY LINE RD HINSDALE IL 60521-4875 (630) 286-4223 INPATIENT - METRO 1/1/17 RUSH OAK PARK HOSPITAL 520 S MAPLE AVE OAK PARK IL 60304-1022 (708) 383-9300 A 11/1/16 INPATIENT - METRO 1/1/17 RUSH UNIVERSITY MEDICAL CENTER 1653 W CONGRESS PKWY CHICAGO IL 60612-3833 (312) 942-5000 A 11/1/16 INPATIENT - METRO 7/1/15 SAINT ANTHONY HOSPITAL 2875 W 19TH ST CHICAGO IL 60623-3501 (773) 484-1000 INPATIENT - METRO 7/1/15 SAINT ANTHONY HOSPITAL 2875 W 19TH ST CHICAGO IL 60623-3501 (773) 484-1000 INPATIENT - METRO 1/1/14 SCHWAB REHABILITATION HOSPITAL 1401 S CALIFORNIA AVE CHICAGO IL 60608-1858 (773) 522-2010 INPATIENT - METRO 1/1/14 SILVER CROSS HOSPITAL 1900 SILVER CROSS BLVD NEW LENOX IL 60451-9508 (815) 300-1100 INPATIENT - METRO 1/1/14 ST ALEXIUS MEDICAL CENTER 1555 BARRINGTON RD HOFFMAN ESTATES IL 60169-1019 (847) 843-2000 INPATIENT - METRO 1/1/14 ST BERNARD HOSPITAL 326 W 64TH ST CHICAGO IL 60621-3114 (773) 962-3900 INPATIENT - METRO 1/1/14 ST JAMES HOSPITAL AND HLTH CNTRS 1423 CHICAGO RD CHICAGO HEIGHTS IL 60411-3400 (708) 756-1000 INPATIENT - METRO 1/1/14 SWEDISH COVENANT HOSPITAL 5145 N CALIFORNIA AVE CHICAGO IL 60625-3661 (773) 878-8200 INPATIENT - METRO 3/1/16 THOREK MEMORIAL HOSPITAL 850 W IRVING PARK RD CHICAGO IL 60613-3077 (773) 525-6780 INPATIENT - METRO 1/1/18 UNION COUNTY HOSPITAL 517 N MAIN ST ANNA IL 62906-1668 (618) 833-4511 A 2/1/18 INPATIENT - METRO 1/1/14 UNIVERSITY OF CHICAGO MEDICAL CEN 5841 S MARYLAND AVE CHICAGO IL 60637-1447 (773) 702-1000 INPATIENT - METRO 1/1/14 VALLEY WEST COMMUNITY HOSPITAL 11 E PLEASANT AVE SANDWICH IL 60548-1100 (815) 786-8484 INPATIENT - METRO 1/1/14 VALLEY WEST COMMUNITY HOSPITAL 11 E PLEASANT AVE SANDWICH IL 60548-1100 (815) 786-8484 INPATIENT - METRO 11/1/17 VAN MATRE HEALTH SOUTH REHAB CTR 950 S MULFORD RD ROCKFORD IL 61108-4274 (815) 381-8500 A 11/1/17 INPATIENT - METRO 7/1/17 VISTA MEDICAL CENTER EAST 1324 N SHERIDAN RD WAUKEGAN IL 60085-2161 (847) 360-3000 A INPATIENT - METRO 1/1/14 WEISS MEMORIAL HOSPITAL 4646 N MARINE DR CHICAGO IL 60640-5759 (773) 878-8700 INPATIENT - METRO 1/1/14 WEISS MEMORIAL HOSPITAL 4646 N MARINE DR CHICAGO IL 60640-5759 (773) 878-8700 INPATIENT - METRO 1/1/14 WEST SUBURBAN MEDICAL CENTER 3 ERIE COURT OAK PARK IL 60302-2519 (708) 383-6200 INPATIENT - METRO 1/1/14 WESTLAKE HOSPITAL INC 1225 W LAKE ST MELROSE PARK IL 60160-4039 (708) 681-3000 13

Eff Organization Name Office Address 1 City State Zip PHONE NUMBER s: A: New C: N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 14

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER MENTAL HEALTH 11/1/15 CHICAGO BEHAVIORAL HOSPITAL 555 WILSON RD DES PLAINES IL 60016-4729 (847) 768-5430 MENTAL HEALTH 1/1/14 LINDEN OAKS HOSPITAL 852 WEST ST NAPERVILLE IL 60540-6400 (630) 305-5500 s: A: New C: N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 15

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER ORTHOTIC & PROSTHETIC 2/1/16 BALLERT ORTHOPEDIC OF CHICAGO 1250 N MILL ST NAPERVILLE IL 60563-6305 (630) 637-9540 ORTHOTIC & PROSTHETIC 2/1/16 BALLERT ORTHOPEDIC OF CHICAGO 139 141 FRONT ST WOOD DALE IL 60191-1509 (630) 694-9305 ORTHOTIC & PROSTHETIC 2/1/16 BALLERT ORTHOPEDIC OF CHICAGO 233 E ERIE ST CHICAGO IL 60611-5938 (312) 787-4400 ORTHOTIC & PROSTHETIC 3/1/15 BALLERT ORTHOPEDIC OF CHICAGO 2434 W PETERSON AVE CHICAGO IL 60659-4113 (773) 878-2445 ORTHOTIC & PROSTHETIC 1/1/17 BENCH MARK ATLANTIC HLTHCARE INC 5407 BULL VALLEY RD MCHENRY IL 60050-7410 (815) 578-0304 ORTHOTIC & PROSTHETIC 1/1/17 GULBRANDSON ORTHO & PROS LTD 2615 THREE OAKS RD CARY IL 60013-6119 (847) 639-4140 ORTHOTIC & PROSTHETIC 3/1/16 HANGER PROSTHETICS & ORTHOTIC INC 1910 S MT ZION RD DECATUR IL 62521-8425 (217) 429-6656 ORTHOTIC & PROSTHETIC 3/1/16 HANGER PROSTHETICS AND ORTHOTICS 3691 COUGAR DR PERU IL 61354-9302 (815) 220-1382 ORTHOTIC & PROSTHETIC 8/1/15 HANGER PROSTHETICS AND ORTHOTICS 311 W ROMEO B GARRETT AVE PEORIA IL 61605-2504 (309) 682-1382 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHO EAST 100 TOWER DR BURR RIDGE IL 60527-5778 (630) 986-0007 ORTHOTIC & PROSTHETIC 8/1/16 HANGER PROSTHETICS ORTHOTICS 4255 WESTBROOK DR AURORA IL 60504-8125 (630) 820-5656 A 9/1/16 ORTHOTIC & PROSTHETIC 1/1/17 HANGER PROSTHETICS ORTHOTICS 620 S ROUTE 31 MCHENRY IL 60050-3134 (815) 344-3070 ORTHOTIC & PROSTHETIC 3/1/16 HANGER PROSTHETICS ORTHOTICS 719 N WILLIAM KUMPF BLVD PEORIA IL 61605-2531 (309) 637-6581 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHOTICS 694 ESSINGTON RD JOLIET IL 60435-4902 (815) 744-9944 ORTHOTIC & PROSTHETIC 1/1/14 3/1/15 HANGER PROSTHETICS ORTHOTICS 75 MARKET ST ELGIN IL 60123-5093 (847) 695-6955 C 2/1/17 ORTHOTIC & PROSTHETIC 3/1/16 3/1/16 HANGER PROSTHETICS ORTHOTICS 7 BRONZE POINTE SOUTH BELLEVILLE IL 62226-8308 (618) 222-7032 C 2/1/17 ORTHOTIC & PROSTHETIC 1/1/14 1/1/14 HANGER PROSTHETICS ORTHOTICS 1 S 224 SUMMIT AVE OAKBROOK TERRACE IL 60181-3938 (630) 620-5333 C 2/1/17 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHOTICS 4525 W LINCOLN HWY MATTESON IL 60443-2318 (708) 679-1006 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHOTICS 4801 W PETERSON AVE CHICAGO IL 60646-5728 (773) 777-9494 ORTHOTIC & PROSTHETIC 1/1/14 11/23/16 HANGER PROSTHETICS ORTHOTICS 1123 EMERSON ST EVANSTON IL 60201-3100 (847) 864-7711 C 2/1/17 ORTHOTIC & PROSTHETIC 1/1/14 1/2/14 HANGER PROSTHETICS ORTHOTICS 10719 W 160TH ST ORLAND PARK IL 60467-5541 (708) 364-1570 C 2/1/17 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHOTICS 10837 S CICERO AVE OAK LAWN IL 60453-5403 (708) 371-9999 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHOTICS 11231 W CERMAK RD WESTCHESTER IL 60154-5706 (708) 447-9860 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHOTICS 17530 S KEDZIE AVE HAZEL CREST IL 60429-2004 (708) 957-0240 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHOTICS 35 TOWER CT GURNEE IL 60031-5712 (847) 623-6080 ORTHOTIC & PROSTHETIC 1/1/14 HANGER PROSTHETICS ORTHOTICS 4255 WESTBROOK DR AURORA IL 60504-8125 (630) 820-5656 ORTHOTIC & PROSTHETIC 7/1/15 NATURALLY YOURS INC 7219 KINGERY HWY WILLOWBROOK IL 60527-7561 (630) 570-5004 ORTHOTIC & PROSTHETIC 10/1/16 RINNELLA ORTHOTICS INC 1890 SILVER CROSS BLVD NEW LENOZ IL 60451-9524 (815) 717-8970 A ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 1725 W HARRISON ST CHICAGO IL 60612-3841 (312) 942-2011 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 1551 BOND ST NAPERVILLE IL 60563-0150 (630) 637-4638 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 1S376 SUMMIT AVE OAK BROOK TERRACE IL 60181-3985 (630) 424-0392 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 2835 N SHEFFIELD CHICAGO IL 60657-5084 (773) 472-3663 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 1740 W TAYLOR ST CHICAGO IL 60612-7232 (312) 996-6450 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 10 N FAIRLANE DR JOLIET IL 60435-5894 (847) 382-3222 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 401 HARRISON ST OAK PARK IL 60304-1427 (708) 383-2257 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 5202 OLD ORCHARD RD SKOKIE IL 60077-4407 (847) 475-7080 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 617 E GOLF RD ARLINGTON HEIGHTS IL 60005-4069 (847) 437-3929 ORTHOTIC & PROSTHETIC 1/1/14 SCHECK AND SIRESS PROSTHETICS INC 8641 W 95TH ST HICKORY HILLS IL 60457-1730 (708) 599-8336 ORTHOTIC & PROSTHETIC 12/1/17 BIONIC PROSTHETICS AND ORTHOTICS 17222 HARLEM AVENUE TINLEY PARK IL 60477-3368 (708) 966-2850 A 2/1/18 ORTHOTIC & PROSTHETIC 12/1/17 BIONIC PROSTHETICS AND ORTHOTICS 17530 KEDZIE AVENUE HAZEL CREST IL 60429-2004 (708) 991-7910 A 2/1/18 ORTHOTIC & PROSTHETIC 12/1/17 BIONIC PROSTHETICS AND ORTHOTICS 4315 N LINCOLN AVENUE CHICAGO IL 60618-1711 (773) 698-6269 A 2/1/18 ORTHOTIC & PROSTHETIC 8/1/17 SECOND ACT LLC 2924 N LINCOLN AVE CHICAGO IL 60657-4109 (773) 525-2228 A 16

Eff Organization Name Office Address 1 City State Zip PHONE NUMBER s: A: New C: N: Prov. Name P: Prov. Number R: Reinstate AC: Accreditation AD: Address CP: prov # changed PN: Name and Number TE: Telephone Number TI: Transfer into a class 17

Medicare Advantage PPO Appendix D Provider Type Eff Organization Name Office Address 1 City State Zip PHONE NUMBER OUTPATIENT SURGERY 1/1/14 ADVENTIST GLEN OAKS HOSPITAL 701 WINTHROP AVE GLENDALE HEIGHTS IL 60139-1405 (630) 545-8000 OUTPATIENT SURGERY 1/1/14 ADVENTIST HINSDALE HOSPITAL 120 N OAK ST HINSDALE IL 60521-3829 (630) 856-9000 OUTPATIENT SURGERY 1/1/14 ADVENTIST LAGRANGE MEMORIAL HOSP 5101 S WILLOW SPRINGS RD LA GRANGE IL 60525-2600 (708) 245-9000 OUTPATIENT SURGERY 1/1/16 ADVOCATE BROMENN MEDICAL CTR 1304 FRANKLIN AVE NORMAL IL 61761-3558 (309) 454-1400 OUTPATIENT SURGERY 1/1/14 ADVOCATE CHRIST HOSP MED CNTR 4440 W 95TH ST OAK LAWN IL 60453-2600 (708) 684-8000 OUTPATIENT SURGERY 1/1/14 ADVOCATE CONDELL MEDICAL CENTER 801 S MILWAUKEE AVE LIBERTYVILLE IL 60048-3204 (847) 362-2900 OUTPATIENT SURGERY 1/1/14 ADVOCATE GOOD SAMARITAN HOSPITAL 3815 HIGHLAND AVE DOWNERS GROVE IL 60515-1500 (630) 275-5900 OUTPATIENT SURGERY 1/1/14 ADVOCATE GOOD SHEPHERD HOSPITAL 450 W HIGHWAY 22 BARRINGTON IL 60010-7509 (847) 381-9600 OUTPATIENT SURGERY 1/1/14 ADVOCATE ILLINOIS MASONIC MED CNT 836 W WELLINGTON AVE CHICAGO IL 60657-5147 (773) 975-1600 OUTPATIENT SURGERY 1/1/14 ADVOCATE LUTHERAN GENERAL HOSP 1775 DEMPSTER ST PARK RIDGE IL 60068-1143 (847) 723-2210 OUTPATIENT SURGERY 1/1/14 ADVOCATE SHERMAN HOSPITAL 1425 N RANDALL RD ELGIN IL 60123 (847) 742-9800 OUTPATIENT SURGERY 1/1/14 ADVOCATE SOUTH SUBURBAN HOSPITAL 17800 S KEDZIE AVE HAZEL CREST IL 60429-2029 (708) 799-8000 OUTPATIENT SURGERY 1/1/14 ADVOCATE TRINITY HOSPITAL 2320 E 93RD ST CHICAGO IL 60617-3983 (773) 967-2000 OUTPATIENT SURGERY 1/1/14 ALEXIAN BROTHERS BEHAVIORAL HLTH 1650 MOON LAKE BLVD HOFFMAN ESTATES IL 60194-1010 (847) 882-1600 OUTPATIENT SURGERY 1/1/14 ALEXIAN BROTHERS MEDICAL CENTER 800 BIESTERFIELD RD ELK GROVE VILLAGE IL 60007-3361 (847) 437-5500 OUTPATIENT SURGERY 11/1/17 AURORA CHICAGO LAKESHORE HOSP 4840 N MARINE DR CHICAGO IL 60640-7860 (773) 878-9700 A OUTPATIENT SURGERY 1/1/17 CENTEGRA HOSPITAL MCHENRY 4201 W MEDICAL CENTER DR MCHENRY IL 60050-8409 (815) 344-5000 A 10/1/16 OUTPATIENT SURGERY 1/1/17 CENTEGRA HOSPITAL WOODSTOCK 3701 DOTY RD WOODSTOCK IL 60098-7509 (815) 338-2500 A 10/1/16 OUTPATIENT SURGERY 1/1/14 CENTRAL DUPAGE HOSPITAL 25 N WINFIELD RD WINFIELD IL 60190-1295 (630) 933-1600 OUTPATIENT SURGERY 11/1/15 CHICAGO BEHAVIORAL HOSPITAL 555 WILSON RD DES PLAINES IL 60016-4729 (847) 768-5430 OUTPATIENT SURGERY 1/1/15 COMMUNITY FIRST MEDICAL CENTER 5645 W ADDISON ST CHICAGO IL 60634-4403 (773) 282-7000 OUTPATIENT SURGERY 1/1/14 COPLEY MEMORIAL HOSPITAL 2000 OGDEN AVE AURORA IL 60504-7222 (630) 978-6200 OUTPATIENT SURGERY 1/1/14 DELNOR COMMUNITY HOSPITAL 300 RANDALL RD GENEVA IL 60134-4200 (630) 208-3000 OUTPATIENT SURGERY 1/1/14 EDWARD HOSPITAL 801 S WASHINGTON ST NAPERVILLE IL 60540-7430 (630) 355-0450 OUTPATIENT SURGERY 1/1/14 ELMHURST MEM HOSPITAL MAIN CAMPUS 155 E BRUSH HILL RD ELMHURST IL 60126-5658 (331) 221-1000 OUTPATIENT SURGERY 1/1/17 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160-1612 (708) 681-3200 A 10/1/16 OUTPATIENT SURGERY 1/1/18 HEARTLAND REGIONAL MEDICAL CTR 3333 W DE YOUNG MARION IL 62959-5884 (618) 998-7000 A OUTPATIENT SURGERY 1/1/14 HOLY CROSS HOSPITAL 2701 W 68TH ST CHICAGO IL 60629-1813 (773) 884-9000 OUTPATIENT SURGERY 1/1/15 INGALLS MEMORIAL HOSPITAL 1 INGALLS DR HARVEY IL 60426-3558 (708) 333-2300 OUTPATIENT SURGERY 11/1/15 KINDRED HOSPITAL CHICAGO NORTH 2544 W MONTROSE CHICAGO IL 60618-1537 (773) 267-2622 A 10/1/16 OUTPATIENT SURGERY 11/1/15 KINDRED HOSPITAL SYCAMORE 225 EDWARD ST SYCAMORE IL 60178-2137 (815) 895-2144 OUTPATIENT SURGERY 1/1/14 LINDEN OAKS HOSPITAL 852 WEST ST NAPERVILLE IL 60540-6400 (630) 305-5500 OUTPATIENT SURGERY 1/1/14 LITTLE COMPANY OF MARY HOSP 2800 W 95TH ST EVERGREEN PARK IL 60805-2701 (708) 422-6200 OUTPATIENT SURGERY 1/1/17 LOYOLA UNIVERSITY MEDICAL CENTER 2160 S FIRST AVE MAYWOOD IL 60153-3328 (708) 216-9000 A 10/1/16 OUTPATIENT SURGERY 1/1/14 MACNEAL HOSPITAL 3249 S OAK PARK AVE BERWYN IL 60402-3429 (708) 783-9100 OUTPATIENT SURGERY 1/1/14 MARIANJOY REHABILITATION HOSPITAL 26 W 171 ROOSEVELT RD WHEATON IL 60187-6078 (630) 909-8000 OUTPATIENT SURGERY 12/1/16 METROSOUTH MEDICAL CENTER 12935 S GREGORY ST BLUE ISLAND IL 60406-2428 (708) 597-2000 OUTPATIENT SURGERY 1/1/14 MOUNT SINAI HOSPITAL 1500 S. CALIFORNIA CHICAGO IL 60608-1704 (773) 542-2000 OUTPATIENT SURGERY 1/1/14 NORTHSHORE EVANSTON HOSPITAL 2650 RIDGE AVE EVANSTON IL 60201-1718 (847) 570-2000 OUTPATIENT SURGERY 1/1/14 NORTHSHORE GLENBROOK HOSPITAL 2100 PFINGSTEN RD GLENVIEW IL 60026-1301 (847) 657-5800 OUTPATIENT SURGERY 1/1/14 NORTHSHORE HIGHLAND PARK HOSPITAL 777 PARK AVE WEST HIGHLAND PARK IL 60035-2433 (847) 432-8000 OUTPATIENT SURGERY 1/1/14 NORTHSHORE SKOKIE HOSPITAL 9600 GROSS POINT RD SKOKIE IL 60076-1214 (847) 677-9600 OUTPATIENT SURGERY 1/1/14 NORTHWEST COMMUNITY HOSPITAL 800 W CENTRAL RD ARLINGTON HEIGHTS IL 60005-2349 (847) 618-1000 OUTPATIENT SURGERY 1/1/17 NORTHWESTERN LAKE FOREST HOSPITAL 660 N WESTMORELAND RD LAKE FOREST IL 60045-1659 (847) 234-5600 A 7/1/17 OUTPATIENT SURGERY 1/1/17 NORTHWESTERN MEMORIAL HOSPITAL 251 E HURON CHICAGO IL 60611-2908 (312) 926-2000 A 7/1/17 OUTPATIENT SURGERY 1/1/14 PALOS COMMUNITY HOSPITAL 12251 S 80TH AVE PALOS HEIGHTS IL 60463-1256 (708) 923-4000 18