Henriquez Ticas, David Omar

Henriquez Ticas, David Omar is an individual health care provider with primary practice located at 710 N Fairbanks Ct Ste 2-458 , Chicago IL 60611-3013. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Henriquez Ticas, David Omar can be contacted via phone (312) 926-3211.

Contact Information

Primary practice address
710 N Fairbanks Ct Ste 2-458 Chicago IL 60611-3013
Phone: (312) 926-3211
Fax: (312) 503-8259
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 036164840 Illinois

Profile Details

NPI number 1922539055
LBN Legal business name Henriquez Ticas, David Omar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2017
Last updated Sep 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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