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  5. LA RABIDA CHILDREN'S HOSPITAL

LA RABIDA CHILDREN'S HOSPITAL

Company Details

Entity Name: LA RABIDA CHILDREN'S HOSPITAL
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 09 Dec 1908
Company Number: CORP_10787602
File Number: 10787602
Address 6501 S PROMONTORY DR 1ST, CHICAGO, IL, 60649
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LA RABIDA CHILDREN'S HOSPITAL CONSOLIDATED WELFARE BENEFIT PLAN 2018 362170143 2019-07-30 LA RABIDA CHILDREN'S HOSPITAL 345
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1979-08-01
Business code 622000
Sponsor’s telephone number 7732565931
Plan sponsor’s mailing address 6501 S PROMONTORY DR, CHICAGO, IL, 606491003
Plan sponsor’s address 6501 S PROMONTORY DR, CHICAGO, IL, 606491003

Number of participants as of the end of the plan year
Active participants 404

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing ESMERALDA DE LA TORRE
Valid signature Filed with authorized/valid electronic signature
LA RABIDA CHILDREN'S HOSPITAL CONSOLIDATED WELFARE BENEFIT PLAN 2017 362170143 2018-04-11 LA RABIDA CHILDREN'S HOSPITAL 369
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1979-08-01
Business code 622000
Sponsor’s telephone number 7737539604
Plan sponsor’s mailing address 6501 S PROMONTORY DR, CHICAGO, IL, 606491003
Plan sponsor’s address 6501 S PROMONTORY DR, CHICAGO, IL, 606491003

Number of participants as of the end of the plan year
Active participants 363
Other retired or separated participants entitled to future benefits 3

Signature of
Role Plan administrator
Date 2018-04-11
Name of individual signing FRANCES LEFKOW
Valid signature Filed with authorized/valid electronic signature
LA RABIDA CHILDREN'S HOSPITAL CONSOLIDATED WELFARE BENEFIT PLAN 2016 362170143 2017-07-26 LA RABIDA CHILDREN'S HOSPITAL 371
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1979-08-01
Business code 622000
Sponsor’s telephone number 7737539604
Plan sponsor’s mailing address 6501 S PROMONTORY DR, CHICAGO, IL, 606491003
Plan sponsor’s address 6501 S PROMONTORY DR, CHICAGO, IL, 606491003

Number of participants as of the end of the plan year
Active participants 403
Retired or separated participants receiving benefits 6

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing FRANCES LEFKOW
Valid signature Filed with authorized/valid electronic signature
LA RABIDA CHILDREN'S HOSPITAL CONSOLIDATED WELFARE BENEFIT PLAN 2015 362170143 2016-10-14 LA RABIDA CHILDREN'S HOSPITAL 305
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1979-08-01
Business code 622000
Sponsor’s telephone number 7737539604
Plan sponsor’s DBA name LA RABIDA CHILDREN'S HOSPITAL
Plan sponsor’s mailing address 6501 S PROMONTORY DR, CHICAGO, IL, 606491003
Plan sponsor’s address 6501 S PROMONTORY DR, CHICAGO, IL, 606491003

Number of participants as of the end of the plan year
Active participants 317
Retired or separated participants receiving benefits 4

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing TOM EVANS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-14
Name of individual signing TOM EVANS
Valid signature Filed with authorized/valid electronic signature
LA RABIDA CHILDREN'S HOSPITAL CONSOLIDATED WELFARE BENEFIT PROGRAM 2014 362170143 2015-07-28 LA RABIDA CHILDREN'S HOSPITAL 291
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1979-08-01
Business code 622000
Sponsor’s telephone number 7737539604
Plan sponsor’s mailing address 6501 SOUTH PROMONTORY DRIVE, CHICAGO, IL, 60649
Plan sponsor’s address 6501 SOUTH PROMONTORY DRIVE, CHICAGO, IL, 60649

Number of participants as of the end of the plan year
Active participants 273
Retired or separated participants receiving benefits 2
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2015-07-28
Name of individual signing TOM EVANS
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ROLLA SWEIS, 6501 SOUTH PROMONTORY DR, CHICAGO, 60649, COOK-NOT IN CITY OF CHICAGO Agent 2024-11-22

Secretary

Name and Address Role Account Number
ERNEST ROTH Secretary 88818

Treasurer

Name and Address Role Account Number
MARK RENFREE Treasurer 86612

Vice president

Name and Address Role Account Number
HOWARD ALPER Vice president 88818

President

Name and Address Role Account Number
ALLEN KANTER President 88818
BRENDA J. WOLF President 86612

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
BUSINESS LICENSE 2217627 Issued 4404 Regulated Business License 232 - Operation of General Medical and Surgical Hospitals 2022-10-18 2022-12-16 2024-12-15
BUSINESS LICENSE 11747 Issued 1006 Retail Food Establishment 775 - Retail Sales of Perishable Foods 2022-10-18 2022-12-16 2024-12-15
BUSINESS LICENSE 67617 Issued 1625 Raffles 720 - Not-For-Profit Selling Raffles for Prizes of $50 or More 2012-08-23 2011-12-16 2012-12-15
BUSINESS LICENSE 11748 Cancelled 1375 Hospital No data 2010-12-14 2010-12-16 2012-12-15

Inspection

Inspection ID Inspection Type Inspection Date License Facility Type Address Risk Results
1528099 Canvass 2015-03-20 11747 Hospital 6500 S COAST GUARD DR, CHICAGO, IL, 60649 Risk 1 (High) Out of Business
920469 Canvass 2014-08-26 11747 Hospital 6500 S COAST GUARD DR, CHICAGO, IL, 60649 Risk 1 (High) Pass
1296501 Canvass 2013-08-05 11747 Hospital 6500 S COAST GUARD DR, CHICAGO, IL, 60649 Risk 1 (High) Pass
1296251 Canvass 2012-12-13 11748 Hospital 6500 S COAST GUARD DR, CHICAGO, IL, 60649 Risk 1 (High) Pass
1296252 Canvass 2012-12-13 11747 Hospital 6500 S COAST GUARD DR, CHICAGO, IL, 60649 Risk 1 (High) Pass
537757 Canvass 2011-12-08 11747 Hospital 6500 S COAST GUARD DR, CHICAGO, IL, 60649 Risk 1 (High) Pass
537758 Canvass 2011-12-08 11748 Hospital 6500 S COAST GUARD DR, CHICAGO, IL, 60649 Risk 1 (High) Pass

Historical Names

Name Change Date
LA RABIDA CHILDREN'S HOSPITAL AND RESEARCH CENTER 2001-07-05

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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