| Entity Name: | SOUTHERN ILLINOIS HOSPITAL SERVICES |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Not-for-Profit |
| Status: | Goodstanding |
| Date Formed: | 15 Apr 1946 |
| Company Number: | CORP_28770766 |
| File Number: | 28770766 |
| Place of Formation: | ILLINOIS |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MBVEXPGAPSK3 | 2024-08-03 | 1239 EAST MAIN ST, CARBONDALE, IL, 62902, USA | 1239 EAST MAIN ST, P.O. BOX 3988, CARBONDALE, IL, 62902, 3988, USA | |||||||||||||||||||||||||||||||||||||||||||
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| Division Name | SOUTHERN ILLINOIS HEALTHCARE |
| Congressional District | 12 |
| State/Country of Incorporation | IL, USA |
| Activation Date | 2023-08-08 |
| Initial Registration Date | 2004-03-02 |
| Entity Start Date | 1946-04-15 |
| Fiscal Year End Close Date | Mar 31 |
Service Classifications
| NAICS Codes | 622110 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | ROSEMARY HOWELL |
| Role | PFS REVENUE INTEGRITY SUPERVISOR |
| Address | 1239 EAST MAIN ST., CARBONDALE, IL, 62902, 3988, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | ROSEMARY HOWELL |
| Role | PFS REVENUE INTEGRITY SUPERVISOR |
| Address | 1239 EAST MAIN ST., CARBONDALE, IL, 62902, 3988, USA |
| Past Performance | Information not Available |
|---|
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTHERN ILLINOIS HEALTHCARE RETIREMENT SAVINGS PLAN | 2022 | 370618939 | 2023-10-16 | SOUTHERN ILLINOIS HOSPITAL SERVICES | 4920 | |||||||||||||||||||||||||||||||||||||
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| Active participants | 4035 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 1191 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 13 |
| Number of participants with account balances as of the end of the plan year | 5082 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 36 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-16 |
| Name of individual signing | MOLLY HAMILTON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2000-04-01 |
| Business code | 622000 |
| Sponsor’s telephone number | 6184575200 |
| Plan sponsor’s mailing address | P.O. BOX 3988, UNIVERSITY MALL, CARBONDALE, IL, 62901 |
| Plan sponsor’s address | 1239 EAST MAIN STREET, CARBONDALE, IL, 62901 |
Number of participants as of the end of the plan year
| Active participants | 3732 |
| Retired or separated participants receiving benefits | 72 |
| Other retired or separated participants entitled to future benefits | 1053 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 12 |
| Number of participants with account balances as of the end of the plan year | 4695 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 70 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-17 |
| Name of individual signing | PAM HENDERSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| JOHN R. DALY, 1239 E MAIN ST, CARBONDALE, 62901, JACKSON | Agent | 2019-04-12 |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| PHARMACY | 054020478 | No data | No data | LICENSED PHARMACY | No data | 2017-10-04 | 2024-01-12 | 2026-03-31 |
| ATHLETIC TRAINER | 186000112 | No data | No data | ATHLETIC TRAINER CONTINUING EDUCATION SPONSOR | No data | 2011-05-13 | 2014-05-02 | 2016-05-31 |
| PHARMACY | 054017030 | No data | No data | LICENSED PHARMACY | No data | 2010-02-01 | 2024-01-06 | 2026-03-31 |
| PHARMACY | 004001380 | No data | No data | LICENSED WHOLESALE DRUG DISTRIBUTOR | No data | 2001-02-14 | 2024-10-02 | 2026-12-31 |
| PHARMACY | 059013391 | No data | No data | LICENSED DIVISION III PHARMACY | No data | 1997-09-09 | 1997-09-09 | 1998-03-31 |
| PHARMACY | 059003559 | No data | No data | LICENSED DIVISION III PHARMACY | No data | 1997-01-01 | 2008-01-10 | 2010-03-31 |
| PHARMACY | 059013328 | No data | No data | LICENSED DIVISION III PHARMACY | No data | 1996-11-07 | 1996-11-07 | 2006-03-31 |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| SIH HERRIN HOSPITAL | NFP Assume Name | 2020-09-10 | No data | No data | No data |
| SIH ST. JOSEPH MEMORIAL HOSPITAL | NFP Assume Name | 2020-09-10 | No data | No data | No data |
| SIH OUTPATIENT REHABILITATION | NFP Assume Name | 2020-09-01 | No data | No data | No data |
| SIH CENTER FOR WOUND HEALING | NFP Assume Name | 2020-09-01 | No data | No data | No data |
| SIH MEMORIAL HOSPITAL OF CARBONDALE | NFP Assume Name | 2020-09-01 | No data | No data | No data |
| SIH SPORTS REHABILITATION | NFP Assume Name | 2020-08-19 | No data | No data | No data |
| SIH CANCER INSTITUTE | NFP Assume Name | 2017-02-21 | No data | No data | No data |
| MEMORIAL HOSPITAL OF CARBONDALE | No data | 2014-12-22 | 2020-08-12 | Voluntary Cancellation | No data |
| CENTER FOR WOUND HEALING | No data | 2014-12-22 | 2020-08-12 | Voluntary Cancellation | No data |
| REHAB UNLIMITED | No data | 2011-05-25 | 2020-08-12 | Voluntary Cancellation | No data |
Date of last update: 13 Jan 2025
