MS. Jack Ching Shaw, OPTICIAN

NPI #1104947316 in Chicago, Illinois

Provider Information

NPI Number: 1104947316
Entity Type: Individual
Name: MS. Jack Ching Shaw, OPTICIAN
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician/Technologist
Credential: OPTICIAN
Enumeration Date: Apr 3, 2007
Last Updated: May 5, 2015

Practice Location

Address: 2906 N BROADWAY ST
City: Chicago
State: Illinois
ZIP Code: 60657-7163
Phone: (773) 525-1601

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist	156F00000X	Primary

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