SYMBRIA RX GREAT LAKES NORTH LLC – Long Term Care Pharmacy, NPI 1104405752
Long Term Care Pharmacy
Main info
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Profile Insights
NPPES metrics only — not quality of care.
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20210908000745 | O | Pharmacy | PA | 2026-09-30 |
| O20220112002516 | O | Pharmacy | PA | 2025-11-30 |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 0124A | Adm sarscv2 bvl 30mcg/.3ml a | 62 | 62 | $0 |
| G0009 | Administration of pneumococcal vaccine | 35 | 35 | $0 |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 32 | 32 | $0 |
Insurance plans in this area (ZIP 60555)
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