Dr. Mitchell Glenn Eustaquio Tan
DNP, APRN,PMHNP-BC | Nurse Practitioner - Psych/Mental Health
1639 N Alpine Rd Ste 260, Rockford
Illinois, 61107-1481
815-670-1715
Dr. Mitchell Glenn Eustaquio Tan is a Rockford, Illinois based nurse practitioner who is specialized as Psych/Mental Health nurse. Active license number of Dr. Mitchell Glenn Eustaquio Tan is 209031254 for Psych/Mental Health in Illinois. His current practice location is 1639 N Alpine Rd Ste 260, Rockford. Patients can reach him at 815-670-1715. Dr. Mitchell Glenn Eustaquio Tan is DNP, APRN,PMHNP-BC with specialization in Psych/Mental Health and his NPI number (Unique professional ID assigned by NPPES) is 1518787696.
Dr. Mitchell Glenn Eustaquio Tan provides a full range of primary mental health care services, including biopsychosocial assessment and diagnosis of patients with mental illness and co-occurring disorders. Treatment modalities include both medication and psychotherapeutic management. Psych/Mental Health Nurse Practitioner (PMHNP) works in a variety of settings, including inpatient, emergency and community-based mental health services.
Complete Profile:
Dr. Mitchell Glenn Eustaquio Tan speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Dr. Mitchell Glenn Eustaquio Tan |
| Specialization: | Psych/Mental Health Nurse Practitioner (PMHNP) |
| Gender: | Male |
| Credentials: | DNP, APRN,PMHNP-BC |
| Practice Address: | 1639 N Alpine Rd Ste 260, Rockford,
Illinois, 61107-1481 |
| Phone: | 815-670-1715 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1518787696 |
| NPI Enumeration Date: | 14 Oct, 2024 |
| NPI Last Update On: | 25 Mar, 2025 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Mitchell Glenn Eustaquio Tan are as mentioned below.
| License Number | Specialization | State | Status | |
| 209031254 | Psych/Mental Health | Illinois | Primary | |
| 4704421713 | Psych/Mental Health | Michigan | Secondary | |
| 041502075 | Registered Nurse | Illinois | Secondary | |
| 1632233 | Psych/Mental Health | Wisconsin | Secondary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Dr. Mitchell Glenn Eustaquio Tan
5126 Silver Fox Trl,
Rockford, Illinois |
| Zip: | 61114-7010 |
| Phone Number: | 815-670-1715 |
Patients can reach Dr. Mitchell Glenn Eustaquio Tan at
1639 N Alpine Rd Ste 260, Rockford, Illinois or can
call to book an appointment on 815-670-1715.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.