Individual
MS. JACK CHING SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
2906 N BROADWAY ST, CHICAGO, IL 60657-7163
(773) 525-1601
(773) 435-4210
Mailing address
2906 N BROADWAY ST, CHICAGO, IL 60657-7163
(773) 525-1601
(773) 435-4210
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
04/03/2007
Last updated
05/05/2015
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