| Doctor Name: | MS. JACK CHING SHAW |
| NPI Number: | 1104947316 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OPTICIAN |
| License Number: | |
| Business Practice Address: | 2906 N Broadway St Chicago, IL - 606577163 |
| Business Phone Number: | 7735251601 |
| Business Fax Number: | 7734354210 |
| Mailing Address: | 2906 N Broadway St, CHICAGO |
| State: | IL |
| Postal Code: | 606577163 |
| Phone Number: | 7735251601 |
| Fax Number: | 7734354210 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 05/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156F00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |