CVS Pharmacy #17175 – Pharmacy, NPI 1346390689
Pharmacy
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for CVS Pharmacy #17175
Target, 4120, West 95th Street, Oak Lawn, Worth Township, Cook County, Illinois, 60453, United States
OAK LAWN, IL 604532675
Phone: (708) 741-4070
Fax: (708) 741-4069
Type: Location
CVS Caremark Corporation, 1, CVS Drive, Woonsocket, Providence County, Rhode Island, 02895, United States
BOX 1075
WOONSOCKET, RI 028956146
Phone: (401) 765-1500
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: 2016-07-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-10-31 (223 days ago).
Enrollment records
1
Earliest due date
2025-10-31
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 |
|---|---|---|---|---|
| O20160721001433 | O | Pharmacy | IL | 2025-10-31 |
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 406 | 35 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 136 | 135 | $0 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | 135 | 134 | $0 |
| G0008 | Administration of influenza virus vaccine | 117 | 116 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 75 | 75 | $0 |
Insurance plans in this area (ZIP 60453)
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