Healthcare Provider Details

I. General information

NPI: 1811087547
Provider Name (Legal Business Name): HILLARY AA CHOLLET MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 PROSPECT AVE STE 338
KANSAS CITY MO
64132-1100
US

IV. Provider business mailing address

503 BUCKEYE DRIVE STE 100
TROY IL
62294-2347
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-6070
  • Fax: 816-361-6105
Mailing address:
  • Phone: 618-692-9640
  • Fax: 618-692-9643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number2002000058
License Number StateMO

VIII. Authorized Official

Name: HILLARY AA CHOLLET
Title or Position: OWNER
Credential: MD
Phone: 816-361-6070