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

Eduardo J Cisneros

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1861384513

Eduardo J Cisneros is a Nurse Practitioner in Northbrook, Illinois. Qualified in 2021, 5 years ago. Practices with Bespoke Psychiatry, a 49-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
5
Licensed in
IL
In the registry since
2025
Specialties on file
2

Practice location Address checks out

5 Revere Dr Ste 200
Northbrook, IL 60062-8000
Phone: (312) 600-3991
Fax: (630) 473-2232
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 209034192 (IL)
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X · Licence 041524344 (IL)

Record details

NPI number1861384513
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 17, 2025
Last updated in NPPESDecember 31, 2025
Certification dateDecember 31, 2025
Mailing address4824 N Tripp Ave, Chicago, IL 60630-2721

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Bespoke Psychiatry — 49 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Northbrook