Symbria Rx Great Lakes South 1 – Long Term Care Pharmacy, NPI 1902569676
Long Term Care Pharmacy
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Symbria Rx Great Lakes South 1
7125 JANES AVE STE 300
WOODRIDGE, IL 605172304
Phone: (630) 413-5800
Fax: (630) 413-5801
Type: Mailing
28100 TORCH PKWY STE 600
WARRENVILLE, IL 605554030
Phone: (630) 413-5800
Type: Mailing
307 23RD STREET EXT
STE 164
SHARPSBURG, PA 152152821
Phone: (724) 545-1600
Type: Location
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: 2022-03-29
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-12-31 (166 days ago).
Enrollment records
2
Earliest due date
2025-12-31
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 |
|---|---|---|---|---|
| O20201110003290 | O | Pharmacy | PA | 2026-02-28 |
| O20220329001586 | O | Pharmacy | PA | 2025-12-31 |
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 |
|---|---|---|---|---|
| 91320 | Sarscv2 vac 30mcg trs-suc im | 622 | 622 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 620 | 620 | $0 |
| G0008 | Administration of influenza virus vaccine | 312 | 312 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 311 | 311 | $0 |
| 0124A | Adm sarscv2 bvl 30mcg/.3ml a | 41 | 41 | $0 |
Insurance plans in this area (ZIP 60517)
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