# GRAYSLAKE MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437236015
- **Authorized official:** DR. ROBERT ROMANELLI M.D. (PRESIDENT)
- **Authorized official phone:** (847) 548-8269

## Contact information

- **Practice address:** 900 TECHNOLOGY WAY STE 230, LIBERTYVILLE, IL 60048-5364
- **Practice address phone:** (847) 548-8269
- **Practice address fax:** (847) 548-8969
- **Mailing address:** 900 TECHNOLOGY WAY STE 230, LIBERTYVILLE, IL 60048-5364
- **Mailing address phone:** (847) 548-8269
- **Mailing address fax:** (847) 548-8969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036095667 | IL | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 09/18/2018