SYMBRIA RX GREAT LAKES NORTH LLC – Long Term Care Pharmacy, NPI 1104405752

SYMBRIA RX GREAT LAKES NORTH LLC is a healthcare provider. based in Warrenville, Illinois. specializing in Long Term Care Pharmacy. The NPI Number for SYMBRIA RX GREAT LAKES NORTH LLC is 1104405752

Main info

Organization
Name
SYMBRIA RX GREAT LAKES NORTH LLC
NPI
1104405752
Phone
Not provided
Address
28100 TORCH PKWY STE 600
Authorized Official
MR. DEREK BROWN VICE PRESIDENT OF PHARMACY
Enumeration Date
2 April 2021
Last Update Date
19 November 2025

Contacts

Secure Messaging
rxcontracting@symbria.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness95
Years active:5State licenses:0Other names

Provider Addresses for SYMBRIA RX GREAT LAKES NORTH LLC

  • 28100 TORCH PKWY STE 600

    WARRENVILLE, IL 605554030

    Phone:

    Type: Mailing

  • 740 N MAIN STREET EXT

    MEADVILLE, PA 163351149

    Phone: (814) 724-3107

    Type: Location

  • 7125 JANES AVE STE 300

    WOODRIDGE, IL 605172304

    Phone: (630) 413-5800

    Fax: (630) 413-5801

    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: 2022-01-12

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-11-30 (197 days ago).

Enrollment records

2

Earliest due date

2025-11-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20210908000745OPharmacyPA2026-09-30
O20220112002516OPharmacyPA2025-11-30

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
0124AAdm sarscv2 bvl 30mcg/.3ml a6262$0
G0009Administration of pneumococcal vaccine3535$0
90677Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use3232$0
View full utilization report →

Insurance plans in this area (ZIP 60555)

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Reviews

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Frequently asked questions

What identifier follows SYMBRIA RX GREAT LAKES NORTH LLC across health systems?
The NPI 1104405752 uniquely identifies SYMBRIA RX GREAT LAKES NORTH LLC in U.S. healthcare data.
Is SYMBRIA RX GREAT LAKES NORTH LLC currently accepting referrals based on NPI status?
Registry metadata lists SYMBRIA RX GREAT LAKES NORTH LLC as active.
Which specialty label fits SYMBRIA RX GREAT LAKES NORTH LLC?
NPPES ties SYMBRIA RX GREAT LAKES NORTH LLC to Long Term Care Pharmacy in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is SYMBRIA RX GREAT LAKES NORTH LLC tied to Warrenville, Illinois?
If you are local to Warrenville, Illinois, SYMBRIA RX GREAT LAKES NORTH LLC may be relevant to your search.
Can I export SYMBRIA RX GREAT LAKES NORTH LLC's record?
You can download the official NPPES record; we summarize key fields for readability.

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