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  5. WASHINGTON SQUARE HEALTH FOUNDATION, INC.

WASHINGTON SQUARE HEALTH FOUNDATION, INC.

Company Details

Entity Name: WASHINGTON SQUARE HEALTH FOUNDATION, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 23 Oct 1901
Company Number: CORP_08483213
File Number: 08483213
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2023 361210140 2024-05-17 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2024-05-16
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2022 361210140 2023-05-17 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2023-05-17
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2021 361210140 2022-05-19 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2022-05-19
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-19
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2020 361210140 2021-02-02 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2021-02-01
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2019 361210140 2020-01-24 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2020-01-24
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2018 361210140 2019-03-28 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2019-03-28
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2017 361210140 2018-04-25 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2018-04-25
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2016 361210140 2017-01-17 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2017-01-17
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2015 361210140 2016-02-17 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 N MICHIGAN AVE STE 3516, SUITE 3516, CHICAGO, IL, 606111957
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2016-02-16
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature
WASHINGTON SQUARE HEALTH FOUNDATION 403B PLAN 2014 361210140 2015-01-27 WASHINGTON SQUARE HEALTH FOUNDATION 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 813000
Sponsor’s telephone number 3126646488
Plan sponsor’s address 875 NORTH MICHIGAN AVENUE, SUITE 3516, CHICAGO, IL, 60611

Plan administrator’s name and address
Administrator’s EIN 361210140
Plan administrator’s name WASHINGTON SQUARE HEALTH FOUNDATION
Plan administrator’s address 875 NORTH MICHIGAN AVENUE, SUITE 3516, CHICAGO, IL, 60611
Administrator’s telephone number 3126646488

Signature of
Role Plan administrator
Date 2015-01-27
Name of individual signing HOWARD NOCHUMSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
CATHERINE YVONNE KAPELLA, 875 N MICHIGAN AVE STE 3900, CHICAGO, 60611, COOK-NOT IN CITY OF CHICAGO Agent 2024-10-31

Historical Names

Name Change Date
HENROTIN HOSPITAL 1986-02-07

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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