Ms. Jack Ching Shaw
Technician/Technologist
2906 N Broadway St
Chicago
, Illinois 60657-7163
Ms. Jack Ching Shaw
Technician/Technologist
2906 N Broadway St
Chicago
, Illinois 60657-7163
(773) 435-4210
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About
Features
Specialties
- Technician/Technologist
Languages spoken
- English
Location
First Address
- Ms. Jack Ching Shaw
- 2906 N Broadway St
- Chicago, IL
- Zip : 60657-7163
- Fax : (773) 435-4210
- Phone : (773) 525-1601
Second Address
- Ms. Jack Ching Shaw
- 2906 N Broadway St
- Chicago, IL
- Zip : 60657-7163
- Fax : (773) 435-4210
- Phone : (773) 525-1601
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 156F00000X | Technician/Technologist |
National Provider Identifier
| NPI | 1104947316 |
|---|---|
| Provider Name | Ms. Jack Ching Shaw |
| First Address | Chicago, IL 60657-7163 |
| Second Address | Chicago, IL 60657-7163 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/04/2007 |
| Last Update Date | 05/05/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.