Provider Demographics
NPI:1306443833
Name:INSTITUTE FOR HIGHER PERFORMANCE
Entity type:Organization
Organization Name:INSTITUTE FOR HIGHER PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-952-7792
Mailing Address - Street 1:10 MONROE BLVD APT 6S
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4359
Mailing Address - Country:US
Mailing Address - Phone:312-952-7792
Mailing Address - Fax:
Practice Address - Street 1:55 E MONROE ST STE 3800
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6030
Practice Address - Country:US
Practice Address - Phone:312-952-7792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)