Provider Demographics
NPI:1265653489
Name:BEMARK, INC.
Entity Type:Organization
Organization Name:BEMARK, INC.
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRANCHISEE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVELOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-745-1767
Mailing Address - Street 1:6560 W FULLERTON AVE
Mailing Address - Street 2:SUITE C-118, PEARLE VISION
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3439
Mailing Address - Country:US
Mailing Address - Phone:773-745-1767
Mailing Address - Fax:773-745-0127
Practice Address - Street 1:6560 W FULLERTON AVE
Practice Address - Street 2:SUITE C-118, PEARLE VISION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-3439
Practice Address - Country:US
Practice Address - Phone:773-745-1767
Practice Address - Fax:773-745-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1610-4625332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier