Provider Demographics
NPI:1659492346
Name:MBMJ, INC.
Entity Type:Organization
Organization Name:MBMJ, INC.
Other - Org Name:PEARLE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-910-1600
Mailing Address - Street 1:1001 75TH ST
Mailing Address - Street 2:SUITE 157
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-2608
Mailing Address - Country:US
Mailing Address - Phone:630-910-1600
Mailing Address - Fax:
Practice Address - Street 1:1001 75TH ST
Practice Address - Street 2:SUITE 157
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2608
Practice Address - Country:US
Practice Address - Phone:630-910-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty