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SUBURBAN OTOLARYNGOLOGY, S. C.

Company Details

Entity Name: SUBURBAN OTOLARYNGOLOGY, S. C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Converted
Date Formed: 09 Dec 1968
Company Number: CORP_49280157
File Number: 49280157
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 26 Oct 2021
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2016 362671108 2017-07-25 SUBURBAN OTOLARYNGOLOGY S.C. 16
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2016 362671108 2017-05-23 SUBURBAN OTOLARYNGOLOGY S.C. 16
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2015 362671108 2016-06-02 SUBURBAN OTOLARYNGOLOGY S.C. 16
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2014 362671108 2015-06-09 SUBURBAN OTOLARYNGOLOGY S.C. 16
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2013 362671108 2014-07-11 SUBURBAN OTOLARYNGOLOGY S.C. 16
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402

Signature of

Role Plan administrator
Date 2014-07-11
Name of individual signing PAUL BOGOSLAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-11
Name of individual signing PAUL BOGOSLAW
Valid signature Filed with authorized/valid electronic signature
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2012 362671108 2013-05-24 SUBURBAN OTOLARYNGOLOGY S.C. 15
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402

Signature of

Role Plan administrator
Date 2013-05-24
Name of individual signing PAUL H. BOGOSLAW
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-24
Name of individual signing PAUL H. BOGOSLAW
Valid signature Filed with authorized/valid electronic signature
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2011 362671108 2012-07-26 SUBURBAN OTOLARYNGOLOGY S.C. 15
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402

Plan administrator’s name and address

Administrator’s EIN 362671108
Plan administrator’s name SUBURBAN OTOLARYNGOLOGY S.C.
Plan administrator’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402
Administrator’s telephone number 7087493070

Signature of

Role Plan administrator
Date 2012-07-26
Name of individual signing LARRY BAILEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-26
Name of individual signing LARRY BAILEY
Valid signature Filed with authorized/valid electronic signature
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2010 362671108 2011-10-07 SUBURBAN OTOLARYNGOLOGY S.C. 16
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402

Plan administrator’s name and address

Administrator’s EIN 362671108
Plan administrator’s name SUBURBAN OTOLARYNGOLOGY S.C.
Plan administrator’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402
Administrator’s telephone number 7087493070

Signature of

Role Plan administrator
Date 2011-10-06
Name of individual signing LARRY BAILEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-06
Name of individual signing LARRY BAILEY
Valid signature Filed with authorized/valid electronic signature
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2009 362671108 2010-10-12 SUBURBAN OTOLARYNGOLOGY S.C. 15
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402

Plan administrator’s name and address

Administrator’s EIN 362671108
Plan administrator’s name SUBURBAN OTOLARYNGOLOGY S.C.
Plan administrator’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402
Administrator’s telephone number 7087493070

Signature of

Role Plan administrator
Date 2010-10-12
Name of individual signing LARRY BAILEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing LARRY BAILEY
Valid signature Filed with authorized/valid electronic signature
SUBURBAN OTOLARYNGOLOGY S.C. PROFIT SHARING & 401(K) PLAN 2009 362671108 2010-10-12 SUBURBAN OTOLARYNGOLOGY S.C. 15
Three-digit plan number (PN) 004
Effective date of plan 1987-02-01
Business code 621111
Sponsor’s telephone number 7087493070
Plan sponsor’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402

Plan administrator’s name and address

Administrator’s EIN 362671108
Plan administrator’s name SUBURBAN OTOLARYNGOLOGY S.C.
Plan administrator’s address 3340 S. OAK PARK AVENUE, BERWYN, IL, 60402
Administrator’s telephone number 7087493070

Signature of

Role Plan administrator
Date 2010-10-12
Name of individual signing LARRY BAILEY
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing LARRY BAILEY
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name and Address Role Appointment Date
DANIEL M KURTZMAN, 3340 S OAK PARK AVE STE 204, BERWYN, 60402, COOK-NOT IN CITY OF CHICAGO Agent 2016-11-10

President

Name and Address Role
DANIEL KURTZMAN, 2440 N LAKEVIEW DRIVE #8A, CHICAGO IL 60614 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 1000 301000 No data

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State