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Orthopaedic Trauma Consultants of Idaho PLLC

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Company Details

Name: Orthopaedic Trauma Consultants of Idaho PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 01 Jan 2019 (7 years ago)
Financial Date End: 31 Jan 2026
Entity Number: 3385876
Place of Formation: IDAHO
File Number: 648698
ZIP code: 83616
County: Ada County
Principal Address: 2130 E GRANITE COVE LN EAGLE, ID 83616-6701

Agent

Name Role Address
Jesse D Chlebeck Agent 2130 E GRANITE COVE LN, EAGLE, ID 83616

Manager

Name Role Address Appointed On
JESSE DYLAN CHLEBECK Manager 2130 E GRANITE COVE LN, EAGLE, ID 83616 2025-04-07

National Provider Identifier

NPI Number:
1336907450
Certification Date:
2024-04-09

Authorized Person:

Name:
JESSE DYLAN CHLEBECK
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207X00000X - Orthopaedic Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
8555922514

Filing

Filing Name Filing Number Filing date
Annual Report 0006197919 2025-04-07
Statement of Merger (Survivor) 0005687159 2024-04-11
Application for Reinstatement 0005660301 2024-03-27
Dissolution/Revocation - Administrative 0004240346 2021-04-08
Annual Report 0003772217 2020-02-06

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Date of last update: 06 Jul 2025

Sources: Idaho Secretary of State