CONSOLIDATED PATHOLOGY CONSULTANTS SC – Anatomic Pathology & Clinical Pathology Physician, NPI 1003884206
Anatomic Pathology & Clinical Pathology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CONSOLIDATED PATHOLOGY CONSULTANTS SC
28100 N Ashley Cir Ste 106
Libertyville, IL 600489478
Phone: (847) 996-1030
Fax: (847) 996-0791
Type: Location
75 REMIHANCE DR
SUITE 1895
CHICAGO, IL 606751895
Phone: (847) 234-0049
Fax: (847) 234-1946
Type: Mailing
Northwestern Medicine Lake Forest Hospital, 1000, North Westmoreland Road, Deerpath, Lake Forest, Lake County, Illinois, 60045, United States
LAKE FOREST, IL 600451658
Phone: (847) 996-1030
Fax: (847) 996-0791
Type: Location
75 REMITTANCE DR DEPT 1895
CHICAGO, IL 606751895
Phone: (630) 874-2744
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2003-12-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-03-31 (69 days ago).
Enrollment records
1
Earliest due date
2026-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20031209000737 | O | Clinic/Group Practice | IL | 2026-03-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60048)
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