Billing 847.570.5000 About NorthShore Home » About NorthShore » Billing » Financial Assistance Financial Assistance NorthShore University HealthSystem’s financial assistance policy offers free care to qualifying patients whose income is at or below 200 percent of the Federal Poverty Level. Patients whose income is above 200 percent of the Federal poverty level or are underinsured may qualify for discounts based on our financial assistance or self pay discount policies. A team of financial counselors at each of our hospitals and many medical office sites, along with our customer service representatives, are ready to assist patients with limited financial resources or limited health coverage. Contact a financial counselor or business office representative by calling the phone number on your statement. They will be able to advise you on potential eligibility and send you a financial assistance application. Complete the application. To complete this document you will need employment, income, expense and asset information. This information must be provided with supporting material, such as pay check stubs and sources of income, bank account statements and income tax forms. Additional information on the application process and supporting documents can be found in the financial assistance policy. Please mail the completed application and supporting documentation to the address listed below, or fax it to 847.982.6957. NorthShore University HealthSystem Patient Financial Services P.O. Box 1006 Suite 330 Skokie, IL 60076-9877 Once the completed application and documentation are received, they will be reviewed and a determination will be made based on your family size and the information provided. You will be notified if you qualify for a reduction of your bill and/or an extended payment plan. Financial Assistance Application English | Arabic | Assyrian | Korean | Mongolian | Polish | Russian | Spanish | Vietnamese Financial Assistance Policy English | Arabic | Assyrian | Korean | Mongolian | Polish | Russian | Spanish | Vietnamese Plain Language Summary English | Arabic | Assyrian | Korean | Mongolian | Polish | Russian | Spanish | Vietnamese Provider Listing (as of 6/2/2021) English | Arabic | Assyrian | Korean | Mongolian | Polish | Russian | Spanish | Vietnamese Billing and Collections Policy English | Arabic | Assyrian | Korean | Mongolian | Polish | Russian | Spanish | Vietnamese Get a Price Estimate For a price estimate or questions regarding hospital charges, please contact 847.982.3924. HOSPITALS Evanston Hospital | 847.570.2000 2650 Ridge Avenue, Evanston, IL 60201 Glenbrook Hospital | 847.657.5800 2100 Pfingsten Road, Glenview IL 60026 Highland Park Hospital | 847.432.8000 777 Park Avenue West, Highland Park, IL 60035 Northwest Community Hospital | 847.618.1000 800 W. Central Road, Arlington Heights, IL 60005 Skokie Hospital | 847.677.9600 9600 Gross Point Road, Skokie, IL 60076 Swedish Hospital | 773.878.8200 5140 N. California Avenue, Chicago, IL 60625 ABOUT NORTHSHORE Medical Group Insurance NorthShore Foundation Research Institute Organization Profile Careers NorthShore Newsroom Community Academics QUICK LINKS Physicians Employees Financial Assistance Health Resources Gift Shop Email a Patient Notice of Privacy Practices Patient Rights Site Map FOLLOW US ON Download the NorthShoreConnect app to access your health information on your mobile phone. A Teaching Affiliate of © 2021 NorthShore University HealthSystem. All Rights Reserved. NorthShore University HealthSystem is a 501(c)3 Nonprofit Organization (EIN: 36-2167060) Website Privacy Policy and Terms of Use