Healthcare Provider Details

I. General information

NPI: 1497695670
Provider Name (Legal Business Name): ASHLEY CHICCHELLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 HOLMES ST
KANSAS CITY MO
64108-2640
US

IV. Provider business mailing address

4408 SPRINGFIELD ST
KANSAS CITY KS
66103-3435
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-1000
  • Fax:
Mailing address:
  • Phone: 319-389-9883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number812004
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: