Individual provider Active NPI

Jacob G Snyder, DPT

  • Physical Therapist
  • Palos Heights, IL
National Provider Identifier
1790540342
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.027315 Issued in IL
Practice address
12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone
(708) 923-4000
NPI assigned
Feb 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.027315 IL Primary

Addresses

Primary practice location

12251 S 80TH Ave
Palos Heights, IL 60463-1290

Mailing address

19432 Kylemore LN
Mokena, IL 60448-8003
Phone (708) 937-4141

Other practice location 1

7040 Centennial Dr
Tinley Park, IL 60477-1649
Phone (708) 400-8063

Other practice location 2

15915 S Crystal Creek Dr Ste H
Homer Glen, IL 60491-9381
Phone (708) 400-8063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409001497 IL Practitioner - Physical Therapist in Private Practice 6204274368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Livestrong Medical PLLCGroup PAC ID 3476082850, 14 clinicians

Practice addresses (Care Compare)

9019 Willow LN
Mokena, IL 60448-8374
Phone (708) 691-4890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.027315ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Livestrong Therapy LLC Physical Therapist CurrentSince Feb 1, 2024 Accepting new patients
Livestrong Medical PLLC CurrentSince Apr 29, 2025 Accepting new patients

Locations

15915 S Crystal Creek Dr
Ste H
Homer Glen, IL 60491
Phone (708) 400-8063

15915 S Crystal Creek Dr
Homer Glen, IL 60491
Phone (708) 301-9596

7040 Centennial Dr
Tinley Park, IL 60477
Phone (708) 400-8063

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1790540342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19432 KYLEMORE LN",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488003",
            "telephone_number": "708-937-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631290",
            "telephone_number": "708-923-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7040 Centennial Dr",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604771649",
            "country_code": "US",
            "telephone_number": "708-400-8063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15915 S Crystal Creek Dr Ste H",
            "address_purpose": "LOCATION",
            "city": "Homer Glen",
            "state": "IL",
            "postal_code": "604919381",
            "country_code": "US",
            "telephone_number": "708-400-8063",
            "fax_number": "708-400-8706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "JACOB",
        "middle_name": "G",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-13",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.027315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.