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  5. GRAHAM HOSPITAL ASSOCIATION

GRAHAM HOSPITAL ASSOCIATION

Company Details

Entity Name: GRAHAM HOSPITAL ASSOCIATION
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 16 Oct 1905
Company Number: CORP_09711732
File Number: 09711732
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
FNKCU1BCWW96 2025-02-14 210 W WALNUT ST, CANTON, IL, 61520, 2444, USA 210 W WALNUT ST, CANTON, IL, 61520, 2444, USA

Business Information
URL https://www.grahamhealthsystem.org/
Congressional District 17
State/Country of Incorporation IL, USA
Activation Date 2024-02-19
Initial Registration Date 2004-03-05
Entity Start Date 1905-01-01
Fiscal Year End Close Date Jun 30

Service Classifications
NAICS Codes 621112, 622110

Points of Contacts
Electronic Business
Title PRIMARY POC
Name KYLE COOK
Role DIRECTOR OF ACCOUNTING
Address 210 W. WALNUT, CANTON, IL, 61520, USA
Title ALTERNATE POC
Name JULIE REEDER
Role CFO
Address 210 W. WALNUT, CANTON, IL, 61520, USA
Government Business
Title PRIMARY POC
Name KYLE COOK
Role DIRECTOR OF ACCOUNTING
Address 210 WEST WALNUT, CANTON, IL, 61520, 2444, USA
Title ALTERNATE POC
Name ROBERT SENNEFF
Address GRAHAM HOSPITAL, 210 W. WALNUT, CANTON, IL, 61520, 2444, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GRAHAM HOSPITAL ASSOCIATION HEALTH PLAN 2019 370673506 2020-06-25 GRAHAM HOSPITAL ASSOCIATION 432
Three-digit plan number (PN) 502
Effective date of plan 1958-01-01
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 444
Retired or separated participants receiving benefits 3
Other retired or separated participants entitled to future benefits 4

Signature of
Role Plan administrator
Date 2020-06-25
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-25
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
SHORT TERM DISABILITY PLAN 2019 370673506 2020-06-25 GRAHAM HOSPITAL ASSOCIATION 531
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1973-03-02
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 581

Signature of
Role Plan administrator
Date 2020-06-25
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-25
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
GRAHAM HOSPITAL ASSOCIATION GROUP LIFE AND LTD 2019 370673506 2020-06-25 GRAHAM HOSPITAL ASSOCIATION 537
Three-digit plan number (PN) 508
Effective date of plan 1973-01-01
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 478

Signature of
Role Plan administrator
Date 2020-06-25
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-25
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
GRAHAM HOSPITAL VISION PLAN 2019 370673506 2020-06-26 GRAHAM HOSPITAL ASSOCIATION 393
Three-digit plan number (PN) 507
Effective date of plan 2009-07-01
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 408
Retired or separated participants receiving benefits 2

Signature of
Role Plan administrator
Date 2020-06-26
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-26
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
GRAHAM HOSPITAL ASSOCIATION GROUP LIFE AND LTD 2018 370673506 2019-07-15 GRAHAM HOSPITAL ASSOCIATION 525
Three-digit plan number (PN) 508
Effective date of plan 1973-01-01
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 537
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1

Signature of
Role Plan administrator
Date 2019-07-15
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
GRAHAM HOSPITAL ASSOCIATION HEALTH PLAN 2018 370673506 2019-07-15 GRAHAM HOSPITAL ASSOCIATION 425
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1958-01-01
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 432
Retired or separated participants receiving benefits 3

Signature of
Role Plan administrator
Date 2019-07-15
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
SHORT TERM DISABILITY PLAN 2018 370673506 2019-07-15 GRAHAM HOSPITAL ASSOCIATION 514
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1973-03-02
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 531

Signature of
Role Plan administrator
Date 2019-07-15
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
GRAHAM HOSPITAL VISION PLAN 2018 370673506 2019-07-15 GRAHAM HOSPITAL ASSOCIATION 397
File View Page
Three-digit plan number (PN) 507
Effective date of plan 2009-07-01
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 393
Retired or separated participants receiving benefits 3
Other retired or separated participants entitled to future benefits 3

Signature of
Role Plan administrator
Date 2019-07-15
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
SHORT TERM DISABILITY PLAN 2017 370673506 2018-07-26 GRAHAM HOSPITAL ASSOCIATION 546
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1973-03-02
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 514

Signature of
Role Plan administrator
Date 2018-07-26
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature
GRAHAM HOSPITAL ASSOCIATION HEALTH PLAN 2017 370673506 2018-07-26 GRAHAM HOSPITAL ASSOCIATION 420
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1958-01-01
Business code 622000
Sponsor’s telephone number 3096475240
Plan sponsor’s mailing address 210 W WALNUT ST, CANTON, IL, 615202444
Plan sponsor’s address 210 W WALNUT ST, CANTON, IL, 615202444

Number of participants as of the end of the plan year
Active participants 425
Retired or separated participants receiving benefits 3

Signature of
Role Plan administrator
Date 2018-07-26
Name of individual signing KYLE COOK
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ROBERT G SENNEFF, GRAHAM HOSPITAL 210 W WALNUT S, CANTON, 61520, FULTON Agent 2006-10-06

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
PHARMACY 054017124 No data No data LICENSED PHARMACY No data 2010-02-03 2024-02-09 2026-03-31
PHARMACY 054017132 No data No data LICENSED PHARMACY No data 2010-02-03 2012-02-21 2014-03-31
PHARMACY 059003399 No data No data LICENSED DIVISION III PHARMACY No data 1997-01-01 2008-01-10 2010-03-31
PHARMACY 058003399 No data No data LICENSED DIVISION II PHARMACY No data 1997-01-01 No data 1996-03-31
PHARMACY 093011289 No data No data LICENSED DIVISION V PHARMACY No data 1992-11-04 2008-01-10 2010-03-31

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PURCHASE ORDER AWARD 61320624N0018 2024-07-01 2025-06-30 2029-06-30
Unique Award Key CONT_AWD_61320624N0018_6100_-NONE-_-NONE-
Awarding Agency Consumer Product Safety Commission
Link View Page

Award Amounts
Obligated Amount 17380.00
Current Award Amount 17380.00
Potential Award Amount 92134.50

Description
Title DATA COLLECTION ON CONSUMER PRODUCT RELATED INJURIES.
NAICS Code 518210: COMPUTING INFRASTRUCTURE PROVIDERS, DATA PROCESSING, WEB HOSTING, AND RELATED SERVICES
Product and Service Codes R702: SUPPORT- MANAGEMENT: DATA COLLECTION

Recipient Details
Recipient GRAHAM HOSPITAL ASSOCIATION
UEI FNKCU1BCWW96
Recipient Address UNITED STATES, 210 W WALNUT ST, CANTON, FULTON, ILLINOIS, 615202444
PURCHASE ORDER AWARD 61320619N0179 2019-07-24 2024-06-30 2024-06-30
Unique Award Key CONT_AWD_61320619N0179_6100_-NONE-_-NONE-
Awarding Agency Consumer Product Safety Commission
Link View Page

Award Amounts
Obligated Amount 13615.04
Current Award Amount 13615.04
Potential Award Amount 13615.04

Description
Title DATA COLLECTION ON CONSUMER PRODUCT RELATED INJURIES.
NAICS Code 518210: COMPUTING INFRASTRUCTURE PROVIDERS, DATA PROCESSING, WEB HOSTING, AND RELATED SERVICES
Product and Service Codes R702: SUPPORT- MANAGEMENT: DATA COLLECTION

Recipient Details
Recipient GRAHAM HOSPITAL ASSOCIATION
UEI FNKCU1BCWW96
Recipient Address UNITED STATES, 210 W WALNUT ST, CANTON, FULTON, ILLINOIS, 615202444

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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