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  5. ELMHURST MEMORIAL HOSPITAL

ELMHURST MEMORIAL HOSPITAL

Company Details

Entity Name: ELMHURST MEMORIAL HOSPITAL
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 28 Mar 1934
Company Number: CORP_23469693
File Number: 23469693
Type of Business: Educational, research or scientific
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
EMVPRPH3B4K8 2024-12-13 155 E BRUSH HILL RD, ELMHURST, IL, 60126, 5658, USA P O BOX 776997, CHICAGO, IL, 60677, 6997, USA

Business Information
URL http://www.eehealth.org
Division Name ELMHURST MEMORIAL HOSPTIAL
Congressional District 04
State/Country of Incorporation IL, USA
Activation Date 2023-12-18
Initial Registration Date 2005-03-17
Entity Start Date 1934-03-28
Fiscal Year End Close Date Jun 30

Service Classifications
NAICS Codes 622110
Product and Service Codes Q301

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JENNIFER ACKERMAN
Role MS
Address 155 E BRUSH HILL RD, ELMHURST, IL, 60126, USA
Title ALTERNATE POC
Name SUZANNE EDWARDS
Address EMH REFERENCE LABORATORY, 155 E BRUSH HILL RD, ELMHURST, IL, 60126, 5658, USA
Government Business
Title PRIMARY POC
Name JENNIFER ACKERMAN
Role MS
Address 155 E BRUSH HILL RD, ELMHURST, IL, 60126, USA
Title ALTERNATE POC
Name CATHY LUTZKE
Address EMH REFERENCE LABORATORY, 155 E BRUSH HILL RD, ELMHURST, IL, 60126, 5658, USA
Past Performance
Title PRIMARY POC
Name SUZANNE EDWARDS
Address EMH REFERENCE LABORATORY, 155 E BRUSH HILL RD, ELMHURST, IL, 60126, 5658, USA
Title ALTERNATE POC
Name CATHY LUTZKE
Address EMH REFERENCE LABORATORY, 155 E BRUSH HILL RD, ELMHURST, IL, 60126, 5658, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ELMHURST MEMORIAL HOSPITAL RETIREMENT PLAN 2013 362167784 2014-10-14 ELMHURST MEMORIAL HOSPITAL 4341
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1964-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Number of participants as of the end of the plan year
Active participants 2180
Retired or separated participants receiving benefits 995
Other retired or separated participants entitled to future benefits 996
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 137
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 116
ELMHURST MEMORIAL HOSPITAL SAVINGS PLAN 2013 362167784 2014-10-14 ELMHURST MEMORIAL HOSPITAL 3666
Three-digit plan number (PN) 004
Effective date of plan 1992-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Number of participants as of the end of the plan year
Active participants 3050
Retired or separated participants receiving benefits 13
Other retired or separated participants entitled to future benefits 650
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 2246
ELMHURST MEMORIAL HOSPITAL SAVINGS PLAN 2013 362167784 2014-10-15 ELMHURST MEMORIAL HOSPITAL 3666
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1992-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Number of participants as of the end of the plan year
Active participants 3050
Retired or separated participants receiving benefits 13
Other retired or separated participants entitled to future benefits 650
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 2246
ELMHURST MEMORIAL HOSPITAL RETIREMENT PLAN 2012 362167784 2013-10-15 ELMHURST MEMORIAL HOSPITAL 4902
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1964-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Number of participants as of the end of the plan year
Active participants 2312
Retired or separated participants receiving benefits 944
Other retired or separated participants entitled to future benefits 947
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 138
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 196

Signature of
Role Plan administrator
Date 2013-10-10
Name of individual signing SUSAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-10
Name of individual signing SUSAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
ELMHURST MEMORIAL HOSPITAL SAVINGS PLAN 2012 362167784 2013-10-15 ELMHURST MEMORIAL HOSPITAL 3880
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1992-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Number of participants as of the end of the plan year
Active participants 3067
Retired or separated participants receiving benefits 35
Other retired or separated participants entitled to future benefits 562
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2
Number of participants with account balances as of the end of the plan year 2209

Signature of
Role Plan administrator
Date 2013-10-10
Name of individual signing SUSAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-10
Name of individual signing SUSAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
EMPLOYEES GROUP LONG TERM DISABILITY 2011 362167784 2013-07-24 ELMHURST MEMORIAL HOSPITAL 1939
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Plan administrator’s name and address
Administrator’s EIN 362167784
Plan administrator’s name ELMHURST MEMORIAL HOSPITAL
Plan administrator’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Administrator’s telephone number 3312211000

Number of participants as of the end of the plan year
Active participants 2275

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing LOIS GRUBB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-11
Name of individual signing LOIS GRUBB
Valid signature Filed with authorized/valid electronic signature
SUPERIOR VISION PLAN 2011 362167784 2013-07-24 ELMHURST MEMORIAL HOSPITAL 880
File View Page
Three-digit plan number (PN) 505
Effective date of plan 2001-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Plan administrator’s name and address
Administrator’s EIN 362167784
Plan administrator’s name ELMHURST MEMORIAL HOSPITAL
Plan administrator’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Administrator’s telephone number 3312211000

Number of participants as of the end of the plan year
Active participants 1040

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing LOIS GRUBB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-11
Name of individual signing LOIS GRUBB
Valid signature Filed with authorized/valid electronic signature
GROUP HEALTH PLAN 2011 362167784 2013-07-24 ELMHURST MEMORIAL HOSPITAL 1666
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1985-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Plan administrator’s name and address
Administrator’s EIN 362167784
Plan administrator’s name ELMHURST MEMORIAL HOSPITAL
Plan administrator’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Administrator’s telephone number 3312211000

Number of participants as of the end of the plan year
Active participants 1882

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing LOIS GRUBB
Valid signature Filed with authorized/valid electronic signature
GROUP DENTAL PLAN 2011 362167784 2013-07-24 ELMHURST MEMORIAL HOSPITAL 1749
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1996-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Plan administrator’s name and address
Administrator’s EIN 362167784
Plan administrator’s name ELMHURST MEMORIAL HOSPITAL
Plan administrator’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Administrator’s telephone number 3312211000

Number of participants as of the end of the plan year
Active participants 1966

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing LOIS GRUBB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-11
Name of individual signing LOIS GRUBB
Valid signature Filed with authorized/valid electronic signature
ELMHURST MEMORIAL HOSPITAL SAVINGS PLAN 2011 362167784 2012-10-15 ELMHURST MEMORIAL HOSPITAL 3546
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1992-01-01
Business code 622000
Sponsor’s telephone number 3312211000
Plan sponsor’s mailing address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Plan sponsor’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126

Plan administrator’s name and address
Administrator’s EIN 362167784
Plan administrator’s name ELMHURST MEMORIAL HOSPITAL
Plan administrator’s address 155 E. BRUSH HILL ROAD, ELMHURST, IL, 60126
Administrator’s telephone number 3312211000

Number of participants as of the end of the plan year
Active participants 3326
Retired or separated participants receiving benefits 32
Other retired or separated participants entitled to future benefits 520
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2
Number of participants with account balances as of the end of the plan year 2219

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing LOIS GRUBB
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SHIVANI BAUTISTA, 4201 WINFIELD RD, WARRENVILLE, 60555, DU PAGE Agent 2023-05-05

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
PHARMACY 054022708 No data No data LICENSED PHARMACY No data 2024-01-26 2024-01-26 2026-03-31
PHARMACY 054017219 No data No data LICENSED PHARMACY No data 2010-02-11 2010-02-11 2012-03-31
PHARMACY 054017217 No data No data LICENSED PHARMACY No data 2010-02-11 2014-02-04 2016-03-31
PHARMACY 054017197 No data No data LICENSED PHARMACY No data 2010-02-11 2024-01-07 2026-03-31
PHARMACY 093013414 No data No data LICENSED DIVISION V PHARMACY No data 1999-09-02 2008-01-10 2010-03-31
PHARMACY 059002818 No data No data LICENSED DIVISION III PHARMACY No data 1997-01-01 2008-01-10 2010-03-31
PHARMACY 093002818 No data No data LICENSED DIVISION V PHARMACY No data 1997-01-01 2008-01-10 2010-03-31
SOCIAL WORKER 159000508 No data No data REGISTERED SOCIAL WORKER CE SPONSOR No data 1996-01-31 2011-10-31 2013-11-30

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
ENDEAVOR HEALTH ELMHURST HOSPITAL NFP Assume Name 2024-05-08 No data No data No data
ELMHURST HOSPITAL, PART OF ENDEAVOR HEALTH No data 2023-12-06 2024-05-08 Voluntary Cancellation No data
ELMHURST HOSPITAL OUTPATIENT PHARMACY NFP Assume Name 2023-08-21 No data No data No data
ENDEAVOR HEALTH No data 2018-08-30 2023-12-06 Voluntary Cancellation No data
ELMHURST HOSPITAL NFP Assume Name 2015-11-02 No data No data No data

Historical Names

Name Change Date
MEMORIAL HOSPITAL OF DU PAGE COUNTY, ELMHURST, ILLINOIS 1983-03-16

Related by officers

SHIVANI BAUTISTA, 4201 WINFIELD RD, WARRENVILLE, 60555, DU PAGE

EDWARD HOSPITAL EDWARD HEALTH VENTURES EDWARD HEALTH AND FITNESS CENTER EDWARD FOUNDATION ELMHURST MEMORIAL HEALTHCARE EDWARD PLAINFIELD HOSPITAL

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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