Type of Institution:

Non Profit Organization

Legal Name of Applicant:

Children’s Memorial Hospital

Authorized Institutional Official:

Harmony Maple, MPA

Director

Office of Sponsored Programs

2300 Children’s Plaza, No. 205

Chicago, IL 60614-3363

T. 773.755.6334  F. 773.755.6533

hmaple@childrensmemorial.org

Industry & Clinical Trial Contract Negotiations:

Kris Martens, JD
Assistant Director

Office of Sponsored Programs

2300 Children’s Plaza, No. 205

Chicago, IL 60614-3363

T. 773-755-6561  F. 773.755.6533

kmartens@childrensmemorial.org

Institutional Address:

Children’s Memorial Hospital

Office of Sponsored Programs

2300 Children’s Plaza, No. 205

Chicago, IL 60614

Federal Express Mailing Address:

Children’s Memorial Research Center

2430 N. Halsted, No. 205

Chicago, IL 60614

Human Subjects Assurance Number:  FWA00001011  

For additional Assurance information, go to:

Office of Human Research Protections

Employee Identification Number (EIN) and Federal Tax ID Number: 

36-2170833

IRB Policies and Procedures:

IRB Policy and Procedure Manual

IRB Fees:

$2,000 for Initial IRB Review

For all other IRB fees contact:

Harmony Maple

773.755.6334
hmaple@childrensmemorial.org

Fringe Benefits Rates:

26%

For a breakdown contact OSP staff

Facilities & Administrative Rates / Indirect Cost Rate:

Clinical Trials Sponsored by Industry 25%

Laboratory Information Systems Contact:

Nalini Merchant 

773.880.4773

nmerchan@childrensmemorial.org

Pharmacy Fees Contact:

Denise Rizzo

773.880.4653

drizzo@childrensmemorial.org

Checks should be made payable to:

Children’s Memorial Hospital

Checks should be sent to:

Roberta Gerard

Assistant Director

Office of Sponsored Programs

2300 Children’s Plaza, No. 205

Chicago, IL 60614-3363

Wire Transfer Information Contact:

Debra Marsh

312.573.8470

dmarsh@childrensmemorial.org

Proof of Insurance Information:

For Information about

Institutional Affiliates, go to:

Northwestern University Feinberg School of Medicine