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  5. HSHS HOLY FAMILY HOSPITAL, INC.

HSHS HOLY FAMILY HOSPITAL, INC.

Company Details

Entity Name: HSHS HOLY FAMILY HOSPITAL, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 03 Apr 1956
Company Number: CORP_35981853
File Number: 35981853
Type of Business: Educational, research or scientific
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GREENVILLE REGIONAL HOSPITAL, INC. HEALTH BENEFIT PLAN 2011 370792770 2012-10-13 GREENVILLE REGIONAL HOSPITAL, INC. 226
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1989-08-01
Business code 622000
Sponsor’s telephone number 3186640808
Plan sponsor’s mailing address 200 HEALTHCARE DRIVE, GREENVILLE, IL, 622461154
Plan sponsor’s address 200 HEALTHCARE DRIVE, GREENVILLE, IL, 622461154

Plan administrator’s name and address
Administrator’s EIN 370792770
Plan administrator’s name GREENVILLE REGIONAL HOSPITAL, INC.
Plan administrator’s address 200 HEALTHCARE DRIVE, GREENVILLE, IL, 622461154
Administrator’s telephone number 3186640808

Number of participants as of the end of the plan year
Active participants 215
Retired or separated participants receiving benefits 7

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing VICKI KLOECKNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-12
Name of individual signing SHERRY KOEHLER
Valid signature Filed with authorized/valid electronic signature
GREENVILLE REGIONAL HOSPITAL, INC. HEALTH BENEFIT PLAN 2010 370792770 2011-10-14 GREENVILLE REGIONAL HOSPITAL, INC. 218
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1989-08-01
Business code 622000
Sponsor’s telephone number 3186640808
Plan sponsor’s mailing address 200 HEALTHCARE DRIVE, GREENVILLE, IL, 622461154
Plan sponsor’s address 200 HEALTHCARE DRIVE, GREENVILLE, IL, 622461154

Plan administrator’s name and address
Administrator’s EIN 370792770
Plan administrator’s name GREENVILLE REGIONAL HOSPITAL, INC.
Plan administrator’s address 200 HEALTHCARE DRIVE, GREENVILLE, IL, 622461154
Administrator’s telephone number 3186640808

Number of participants as of the end of the plan year
Active participants 226
Other retired or separated participants entitled to future benefits 7

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing TODD RAY
Valid signature Filed with authorized/valid electronic signature
GREENVILLE REGIONAL HOSPITAL, INC. HEALTH BENEFIT PLAN 2009 370792770 2010-10-13 GREENVILLE REGIONAL HOSPITAL, INC. 295
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1989-08-01
Business code 622000
Sponsor’s telephone number 3186640808
Plan sponsor’s mailing address 200 HEALTH CARE DRIVE, GREENVILLE, IL, 622461154
Plan sponsor’s address GREENVILLE REGIONAL HOSPITAL, INC, 200 HEALTH CARE DRIVE, GREENVILLE, IL, 622461154

Plan administrator’s name and address
Administrator’s EIN 370792770
Plan administrator’s name GREENVILLE REGIONAL HOSPITAL, INC.
Plan administrator’s address 200 HEALTH CARE DRIVE, GREENVILLE, IL, 622461154
Administrator’s telephone number 3186640808

Number of participants as of the end of the plan year
Active participants 623

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing TODD RAY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing TODD RAY
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
PAIGE M. TOTH, 4936 LAVERNA RD, SPRINGFIELD, 62707, SANGAMON Agent 2022-12-05

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
PHARMACY 054017064 No data No data LICENSED PHARMACY No data 2010-02-01 2024-03-28 2026-03-31
PHARMACY 059011379 No data No data LICENSED DIVISION III PHARMACY No data 1993-03-25 2008-01-10 2010-03-31

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
HSHS HOLY FAMILY VANDALIA NFP Assume Name 2020-12-16 No data No data No data
GREENVILLE REGIONAL HOSPITAL NFP Assume Name 2016-05-10 No data No data No data

Historical Names

Name Change Date
GREENVILLE REGIONAL HOSPITAL, INC. 2016-05-02
EDWARD A. UTLAUT MEMORIAL HOSPITAL, INC. 2004-09-24
EDWARD A. UTLAUT FOUNDATION, INC. 1983-08-24

Related by officers

PAIGE M. TOTH, 4936 LAVERNA RD, SPRINGFIELD, 62707, SANGAMON

HSHS GOOD SHEPHERD HOSPITAL, INC. ST. ELIZABETH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS ST. ANTHONY'S MEMORIAL HOSPITAL, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS ST. FRANCIS HOSPITAL, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS ST. JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS ST. JOSEPH'S HOSPITAL, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS ST. MARY'S HOSPITAL, DECATUR, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS UTLAUT MEMORIAL FOUNDATION, INC. ST. JOSEPH'S HOSPITAL, BREESE, OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY, LLC

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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