Active NPI
Jacob Richard Vincent
- Behavior Technician
- Crystal Lake, IL
National Provider Identifier
1215867924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-26-508201
- Practice address
- 183 Heritage Dr Unit 1
Crystal Lake, IL 60014-8051 - Phone
- (847) 376-9191
- NPI assigned
- May 22, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-26-508201 | IL | Primary |
Addresses
Primary practice location
183 Heritage Dr Unit 1
Crystal Lake, IL 60014-8051
Mailing address
282 Haber Rd
Cary, IL 60013-3236
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-26-508201 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779408000000",
"number": "1215867924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "282 HABER RD",
"city": "CARY",
"state": "IL",
"postal_code": "600133236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "183 HERITAGE DR UNIT 1",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600148051",
"telephone_number": "847-376-9191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCENT",
"first_name": "JACOB",
"middle_name": "RICHARD",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-05-22",
"last_updated": "2026-05-22",
"certification_date": "2026-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-26-508201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.