Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

David Omar Henriquez Ticas, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1922539055

David Omar Henriquez Ticas, MD is a Pathology in Chicago, Illinois. Qualified in 2012, 14 years ago. Works from 2 locations. Licensed in Illinois.

Years since qualifying
14
Licensed in
IL
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

710 N Fairbanks Ct Ste 2-458
Chicago, IL 60611-3013
Phone: (312) 926-3211
Fax: (312) 503-8259
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Baylor Plz, Houston, TX 77030-3411 — (713) 798-5490

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 036164840 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1922539055
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 21, 2017
Last updated in NPPESSeptember 6, 2023
Certification dateSeptember 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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