Provider Demographics
NPI:1063614121
Name:GA CONSULTING AND MANAGEMENT, INC
Entity type:Organization
Organization Name:GA CONSULTING AND MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:GOYNSHOR
Authorized Official - Suffix:
Authorized Official - Credentials:MPH,RD,LDN,CDE
Authorized Official - Phone:847-490-4603
Mailing Address - Street 1:401 E ONTARIO ST
Mailing Address - Street 2:APT 808
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3051
Mailing Address - Country:US
Mailing Address - Phone:847-490-4603
Mailing Address - Fax:
Practice Address - Street 1:401 E ONTARIO ST
Practice Address - Street 2:APT 808
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3051
Practice Address - Country:US
Practice Address - Phone:847-490-4603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty