NPI 1104947316

Jack Ching Shaw, OPTICIAN

Practitioner Technician/Technologist Chicago, IL

Practice location

Address: 2906 N Broadway St, Chicago, IL 60657-7163
Phone: (773) 525-1601
Fax: (773) 435-4210

Registered specialties

Technician/Technologist Primary

Eye and Vision Services Providers Taxonomy 156F00000X

Other Technician/Technologist providers in Illinois →

Registry record

NPI: 1104947316
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Apr 2007
Record last updated: 5 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.