Mitchell Glenn Eustaquio Tan, DNP, APRN,PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Rockford, IL
Mitchell Glenn Eustaquio Tan, DNP, APRN,PMHNP-BC is a psychiatric/mental health nurse practitioner with a practice address in Rockford, Illinois, and NPI 1518787696, issued on Oct 14, 2024. Check the license (Illinois 209031254, as entered in NPPES) with the Illinois board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Mitchell Glenn Eustaquio Tan
- Credential
- DNP, APRN,PMHNP-BC
- Primary taxonomy
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License numbers
- 209031254 IL
041502075 IL
4704421713 MI
1632233 WI
Self-reported in NPPES; status is on the state search - Practice location
- 1639 N Alpine RD Ste 260, Rockford, IL 61107
- Phone
- (815) 670-1715
- Enumerated
- Oct 14, 2024
- Record last updated
- Mar 25, 2025
- Medicare enrollment
- Enrolled (PECOS I20250218000210); accepts Medicare assignment
- Telehealth
- Offers telehealth (CMS)
- Entity
- Type 1 · individual
8 nearest psychiatric/mental health nurse practitioner records → All 1,530 in Illinois → Look up another NPI →
Also registered at 1639 N Alpine RD Ste 260
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Misty Dehaven, APNFamily Nurse Practitioner1003384603
- Angela GilbertFamily Nurse Practitioner1356912026
- Malori Hinchen, APRNPsychiatric/Mental Health Nurse Practitioner1013803576
- Candice Holder, PMHNPPsychiatric/Mental Health Nurse Practitioner1376976530
- Casi Krall, M.S., L.C.P.C.Professional Counselor1679848279
- Jenna McPhillips, LCSWClinical Social Worker1043151293
Verify Mitchell Glenn Eustaquio Tan in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Illinois board licenses this profession
Search for license 209031254Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Rockford Psychiatric Medical Services SCRockford, IL
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Mitchell Glenn Eustaquio Tan among 1,530 psychiatric/mental health nurse practitioner records in Illinois
Mitchell Glenn Eustaquio Tan, DNP, APRN,PMHNP-BC is one of 1,530 psychiatric/mental health nurse practitioner records with a practice address in Illinois. 68% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2024, is newer than 67% of them.
- NPI issued2024 · 67% of these records are older, 23% newer
- In a Medicare fileYes · 68% of these records are
- In the CMS Doctors and Clinicians fileYes · 60% of these records are
- Graduated2024 · median 2021 among the 917 with a school on file
- Record last updated2025 · 17% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363LP0808X and a Illinois practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Psychiatric/Mental Health Nurse Practitioner providers in Illinois
There are 1,530 psychiatric/mental health nurse practitioner records in Illinois.
All 1,530 in Illinois → Every provider in Rockford → Psychiatric/Mental Health Nurse Practitioner nationwide →
The 8 psychiatric/mental health nurse practitioner records with the nearest ZIP codes
- David Bachert, APRNRockford, IL 611071154069094
- Debra Corrigan, APNRockford, IL 611071043582273
- Edith De Soto, PMHNP-BCRockford, IL 611071699520932
- Malori Hinchen, APRNRockford, IL 611071013803576
- Candice Holder, PMHNPRockford, IL 611071376976530
- Kendal Justice, PMHNPRockford, IL 611071427802966
- Abigail Lake, DNP, PMHNP-BCRockford, IL 611071730669409
- Amanda Lantow, PMHNPRockford, IL 611071790390326
Common questions
What is Mitchell Glenn Eustaquio Tan, DNP, APRN,PMHNP-BC's NPI number?
Mitchell Glenn Eustaquio Tan, DNP, APRN,PMHNP-BC's National Provider Identifier (NPI) is 1518787696, issued on Oct 14, 2024. An NPI identifies a provider in billing; it is not a license.
Where is Mitchell Glenn Eustaquio Tan, DNP, APRN,PMHNP-BC located?
The NPPES record lists a practice address at 1639 N Alpine RD Ste 260, Rockford, IL, 61107. Phone: (815) 670-1715. Providers update this record themselves, so call before visiting.
How can I verify Mitchell Glenn Eustaquio Tan, DNP, APRN,PMHNP-BC's license?
NPPES lists Illinois license number 209031254, as entered by the provider. Search the Illinois board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.