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  5. NORTHERN ILLINOIS MEDICAL CENTER

NORTHERN ILLINOIS MEDICAL CENTER

Company Details

Entity Name: NORTHERN ILLINOIS MEDICAL CENTER
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 16 Mar 1956
Company Number: CORP_35947523
File Number: 35947523
Type of Business: Not for Profit
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTHERN ILLINOIS MEDICAL CENTER LIFE, AD&D, DEPENDENT LIFE, & LONG TERM DISABILITY 2017 362338884 2018-09-28 NORTHERN ILLINOIS MEDICAL CENTER 3485
File View Page
Three-digit plan number (PN) 519
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 3196

Signature of
Role Plan administrator
Date 2018-09-28
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-28
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
NIMC FLEX BENEFIT PLAN 2017 362338884 2018-09-28 NORTHERN ILLINOIS MEDICAL CENTER 5113
File View Page
Three-digit plan number (PN) 518
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 N. FRONT STREET, SUITE 1, MCHENRY, IL, 600505503
Plan sponsor’s address 213 N. FRONT STREET, SUITE 1, MCHENRY, IL, 600505503

Number of participants as of the end of the plan year
Active participants 4327

Signature of
Role Plan administrator
Date 2018-09-28
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-28
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
NORTHERN ILLINOIS MEDICAL CENTER LIFE, AD&D, DEPENDENT LIFE, & LONG TERM DISABILITY 2016 362338884 2017-10-09 NORTHERN ILLINOIS MEDICAL CENTER 3032
File View Page
Three-digit plan number (PN) 519
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 3485

Signature of
Role Plan administrator
Date 2017-10-09
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-09
Name of individual signing DOUG FENSTERMAKER
Valid signature Filed with authorized/valid electronic signature
NIMC FLEX BENEFIT PLAN 2016 362338884 2017-10-09 NORTHERN ILLINOIS MEDICAL CENTER 4056
File View Page
Three-digit plan number (PN) 518
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 5113

Signature of
Role Plan administrator
Date 2017-10-09
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-09
Name of individual signing DOUG FENSTERMAKER
Valid signature Filed with authorized/valid electronic signature
NORTHERN ILLINOIS MEDICAL CENTER LIFE, AD&D, DEPENDENT LIFE, & LONG TERM DISABILITY 2015 362338884 2016-10-11 NORTHERN ILLINOIS MEDICAL CENTER 2743
File View Page
Three-digit plan number (PN) 519
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 3032

Signature of
Role Plan administrator
Date 2016-10-06
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-10
Name of individual signing DAVID TOMLINSON
Valid signature Filed with authorized/valid electronic signature
NIMC FLEX BENEFIT PLAN 2015 362338884 2016-10-11 NORTHERN ILLINOIS MEDICAL CENTER 4408
File View Page
Three-digit plan number (PN) 518
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 4056

Signature of
Role Plan administrator
Date 2016-10-06
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-10
Name of individual signing DAVID TOMLINSON
Valid signature Filed with authorized/valid electronic signature
NORTHERN ILLINOIS MEDICAL CENTER LIFE, AD&D, DEPENDENT LIFE, & LONG TERM DISABILITY 2014 362338884 2015-10-12 NORTHERN ILLINOIS MEDICAL CENTER 2792
File View Page
Three-digit plan number (PN) 519
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 2743

Signature of
Role Plan administrator
Date 2015-10-08
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-12
Name of individual signing DAVID TOMLINSON
Valid signature Filed with authorized/valid electronic signature
NIMC FLEX BENEFIT PLAN 2014 362338884 2015-10-12 NORTHERN ILLINOIS MEDICAL CENTER 4577
File View Page
Three-digit plan number (PN) 518
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 4408

Signature of
Role Plan administrator
Date 2015-10-08
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-12
Name of individual signing DAVID TOMLINSON
Valid signature Filed with authorized/valid electronic signature
NIMC FLEX BENEFIT PLAN 2013 362338884 2014-10-06 NORTHERN ILLINOIS MEDICAL CENTER 4497
File View Page
Three-digit plan number (PN) 518
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 4577

Signature of
Role Plan administrator
Date 2014-10-03
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-06
Name of individual signing DAVID TOMLINSON
Valid signature Filed with authorized/valid electronic signature
NORTHERN ILLINOIS MEDICAL CENTER LIFE, AD&D, DEPENDENT LIFE, & LONG TERM DISABILITY 2013 362338884 2014-10-06 NORTHERN ILLINOIS MEDICAL CENTER 2759
File View Page
Three-digit plan number (PN) 519
Effective date of plan 1990-07-01
Business code 622000
Sponsor’s telephone number 8157598124
Plan sponsor’s mailing address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050
Plan sponsor’s address 213 N FRONT STREET, SUITE 1, MCHENRY, IL, 60050

Number of participants as of the end of the plan year
Active participants 2792

Signature of
Role Plan administrator
Date 2014-10-03
Name of individual signing ROSA I. JESCHKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-06
Name of individual signing DAVID TOMLINSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JULIA K. LYNCH, 211 E ONTARIO ST STE 1800, CHICAGO, 60611, COOK-NOT IN CITY OF CHICAGO Agent 2023-01-12

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
PHARMACY 054021726 No data No data LICENSED PHARMACY No data 2020-11-19 2024-01-19 2026-03-31
HME AND SERVICES PROV 203002607 No data No data HOME MEDICAL EQUIPMENT AND SERVICES PROVIDER No data 2020-09-25 2024-01-04 2027-03-31
PHARMACY 054020955 No data No data LICENSED PHARMACY No data 2019-02-20 2024-01-06 2026-03-31
PHARMACY 054019998 No data No data LICENSED PHARMACY No data 2016-07-08 2016-07-08 2018-03-31
PHARMACY 054020032 No data No data LICENSED PHARMACY No data 2016-07-08 2020-03-05 2022-03-31
PHARMACY 054018878 No data No data LICENSED PHARMACY No data 2015-01-09 2018-02-20 2020-09-30
HME AND SERVICES PROV 203001371 No data No data HOME MEDICAL EQUIPMENT AND SERVICES PROVIDER No data 2011-11-29 2018-04-02 2021-03-31
HME AND SERVICES PROV 203001307 No data No data HOME MEDICAL EQUIPMENT AND SERVICES PROVIDER No data 2011-03-23 2015-03-30 2018-03-31
PHARMACY 054016972 No data No data LICENSED PHARMACY No data 2010-01-29 2024-02-01 2026-03-31
PHARMACY 059003510 No data No data LICENSED DIVISION III PHARMACY No data 1997-01-01 2008-01-10 2010-03-31

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
NORTHWESTERN MEDICINE HOME MEDICAL EQUIPMENT NFP Assume Name 2021-11-04 No data No data No data
HEALTH BRIDGE CORPORATION NFP Assume Name 2020-09-23 No data No data No data
NORTHWESTERN MEDICINE CRYSTAL LAKE HEALTH & FITNESS CENTER NFP Assume Name 2020-09-23 No data No data No data
NORTHWESTERN MEDICINE CRYSTAL LAKE HEALTH AND FITNESS CENTER NFP Assume Name 2020-09-23 No data No data No data
NORTHWESTERN MEDICINE HUNTLEY HEALTH AND FITNESS CENTER NFP Assume Name 2020-09-21 No data No data No data
CENTEGRA HEALTH BRIDGE FITNESS CENTER NFP Assume Name 2020-09-21 No data No data No data
NORTHWESTERN MEDICINE HUNTLEY HEALTH & FITNESS CENTER NFP Assume Name 2020-09-21 No data No data No data
CENTEGRA HOME MEDICAL EQUIPMENT NFP Assume Name 2019-10-02 No data No data No data
NORTHWESTERN MEDICINE MCHENRY HOSPITAL NFP Assume Name 2018-09-06 No data No data No data
NORTHWESTERN MEDICINE HUNTLEY HOSPITAL NFP Assume Name 2018-09-06 No data No data No data

Historical Names

Name Change Date
MC HENRY HOSPITAL 1982-06-07

Related by officers

JULIA K. LYNCH, 211 E ONTARIO ST STE 1800, CHICAGO, 60611, COOK-NOT IN CITY OF CHICAGO

MEMORIAL MEDICAL CENTER-WOODSTOCK NORTHWESTERN LAKE FOREST HOSPITAL PALOS COMMUNITY HOSPITAL CENTRAL DU PAGE HOSPITAL ASSOCIATION MARIANJOY REHABILITATION HOSPITAL & CLINICS, INC. KISHWAUKEE COMMUNITY HOSPITAL NORTHWESTERN MEMORIAL HOSPITAL NORTHWESTERN MEDICAL FACULTY FOUNDATION CENTRAL DUPAGE PHYSICIAN GROUP NORTHWESTERN MEMORIAL HEALTHCARE

Related by address

No related companies by address

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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