Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mitchell Glenn Eustaquio Tan, DNP, APRN, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1518787696

Dr. Mitchell Glenn Eustaquio Tan, DNP, APRN, PMHNP-BC is a Nurse Practitioner in Rockford, Illinois. Qualified in 2024, 2 years ago. Practices with Rockford Psychiatric Medical Services SC, a 151-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois, Michigan and Wisconsin.

Years since qualifying
2
Licensed in
IL, MI, WI
In the registry since
2024
Specialties on file
4
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

1639 N Alpine Rd Ste 260
Rockford, IL 61107-1481
Phone: (815) 670-1715
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 209031254 (IL)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 4704421713 (MI)
Registered Nurse Taxonomy 163W00000X · Licence 041502075 (IL)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 1632233 (WI)

Record details

NPI number1518787696
Entity typeIndividual (Type 1)
GenderMale
Credentials DNP , APRN , PMHNP-BC
Sole proprietorYes
NPI enumeratedOctober 14, 2024
Last updated in NPPESMarch 25, 2025
Certification dateMarch 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Rockford Psychiatric Medical Services Sc — 151 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Rockford