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General NPI Number Information
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NPI Number | 1306443833
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR HIGHER PERFORMANCE
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 55 E MONROE ST STE 3800
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City | CHICAGO
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State | IL
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Zip | 60603-6030
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Country | US
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Telephone | 312-952-7792
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MONROE BLVD APT 6S
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City | LONG BEACH
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State | NY
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Zip | 11561-4359
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Country | US
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Telephone | 312-952-7792
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. DANIEL JOHN MORAN
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Credential | PH.D.
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Telephone | 312-952-7792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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