# FULL SAIL PARTNERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vision Center@Meijer
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659553642
- **Authorized official:** ERIC BERTRAND (RECEPTIONIST)
- **Authorized official phone:** (574) 936-8144

## Contact information

- **Practice address:** 755 E BOUGHTON RD, BOLINGBROOK, IL 60440-2250
- **Practice address phone:** (630) 783-0225
- **Practice address fax:** (630) 783-0225
- **Mailing address:** PO BOX 8782, KENTWOOD, MI 49518-8782
- **Mailing address phone:** (616) 455-8434
- **Mailing address fax:** (616) 455-8434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/30/2007
- **Last updated:** 11/30/2007