| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1993-01-01
|
| Business code |
813000
|
| Sponsor’s telephone number |
8474244163
|
| Plan sponsor’s
address |
828 DAVIS STREET, SUITE 100, EVANSTON, IL, 60201
|
Plan administrator’s name and address
| Administrator’s EIN |
362374225 |
| Plan administrator’s name |
THE MIDWEST CLINIC |
| Plan administrator’s
address |
828 DAVIS STREET, SUITE 100, EVANSTON, IL, 60201 |
| Administrator’s telephone number |
8474244163 |
Signature of
| Role |
Plan administrator |
| Date |
2010-08-24 |
| Name of individual signing |
KELLY JOCIUS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-08-24 |
| Name of individual signing |
KELLY JOCIUS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
