Healthcare Provider Details

I. General information

NPI: 1598920662
Provider Name (Legal Business Name): JILL LEBSACK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL LINDSTEADT

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E 128TH AVE
THORNTON CO
80241-2601
US

IV. Provider business mailing address

1500 E 128TH AVE
THORNTON CO
80241-2601
US

V. Phone/Fax

Practice location:
  • Phone: 720-972-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2653
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL0011319
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: