Individual
ERIC JON TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
5906 ELAINE DR STE 109, ROCKFORD, IL 61108-2467
(779) 212-4721
Mailing address
7431 E STATE ST STE 354, ROCKFORD, IL 61108-2678
(779) 212-4721
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.13458
IL
Other
Enumeration date
03/08/2021
Last updated
04/21/2025
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