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  5. CAMELOT RADIOLOGY ASSOCIATES, LTD.

CAMELOT RADIOLOGY ASSOCIATES, LTD.

Company Details

Entity Name: CAMELOT RADIOLOGY ASSOCIATES, LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 14 May 1969
Company Number: CORP_49500335
File Number: 49500335
Type of Business: Incorporated under the Medical Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CAMELOT RADIOLOGY ASSOCIATES, LTD. 401(K) PLAN 2023 362671677 2024-09-20 CAMELOT RADIOLOGY ASSOCIATES, LTD. 9
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8155192600
Plan sponsor’s address 3871 N. PERRYVILLE RD, ROCKFORD, IL, 61114

Signature of
Role Plan administrator
Date 2024-09-20
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES, LTD. 401(K) PLAN 2022 362671677 2023-05-24 CAMELOT RADIOLOGY ASSOCIATES, LTD. 9
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8153975554
Plan sponsor’s address 3871 N. PERRYVILLE RD, ROCKFORD, IL, 61114

Signature of
Role Plan administrator
Date 2023-05-22
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES, LTD. 401(K) PLAN 2021 362671677 2022-04-20 CAMELOT RADIOLOGY ASSOCIATES, LTD. 9
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8153975554
Plan sponsor’s address 3871 N. PERRYVILLE RD, ROCKFORD, IL, 61114

Signature of
Role Plan administrator
Date 2022-04-20
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES, LTD. 401(K) PLAN 2021 362671677 2022-09-26 CAMELOT RADIOLOGY ASSOCIATES, LTD. 8
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8153975554
Plan sponsor’s address 3871 N. PERRYVILLE RD, ROCKFORD, IL, 61114

Signature of
Role Plan administrator
Date 2022-09-26
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES, LTD. 401(K) PLAN 2020 362671677 2022-07-25 CAMELOT RADIOLOGY ASSOCIATES, LTD. 7
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8153975554
Plan sponsor’s address 3871 N. PERRYVILLE RD, ROCKFORD, IL, 61114

Signature of
Role Plan administrator
Date 2022-07-25
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES, LTD. 401(K) PLAN 2020 362671677 2021-08-05 CAMELOT RADIOLOGY ASSOCIATES, LTD. 7
Three-digit plan number (PN) 004
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8153975554
Plan sponsor’s address 3871 N. PERRYVILLE RD, ROCKFORD, IL, 61114

Signature of
Role Plan administrator
Date 2021-08-05
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES, LTD. 401(K) PLAN 2019 362671677 2020-10-07 CAMELOT RADIOLOGY ASSOCIATES, LTD. 9
Three-digit plan number (PN) 004
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8153975554
Plan sponsor’s address 3871 N. PERRYVILLE ROAD, ROCKFORD, IL, 61114

Signature of
Role Plan administrator
Date 2020-10-07
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES LTD PENSION PLAN & TRUST 2010 362671677 2012-01-25 CAMELOT RADIOLOGY ASSOCIATES LTD 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1969-08-04
Business code 621111
Sponsor’s telephone number 8159375554
Plan sponsor’s mailing address 3849 N PERRYVILLE RD, ROCKFORD, IL, 61114
Plan sponsor’s address 3849 N PERRYVILLE RD, ROCKFORD, IL, 61114

Plan administrator’s name and address
Administrator’s EIN 362671677
Plan administrator’s name CAMELOT RADIOLOGY ASSOCIATES LTD
Plan administrator’s address 3849 N PERRYVILLE RD, ROCKFORD, IL, 61114
Administrator’s telephone number 8159375554

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-01-20
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES, LTD. CASH BALANCE PLAN 2009 362671677 2012-10-24 CAMELOT RADIOLOGY ASSOCIATES, LTD 1
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8153975554
Plan sponsor’s DBA name C/O NORTHERN ILLINOIS RADIOLOGY
Plan sponsor’s address 3849 N. PERRYVILLE ROAD, ROCKFORD, IL, 61114

Plan administrator’s name and address
Administrator’s EIN 362671677
Plan administrator’s name CAMELOT RADIOLOGY ASSOCIATES, LTD
Plan administrator’s address 3849 N. PERRYVILLE ROAD, ROCKFORD, IL, 61114
Administrator’s telephone number 8153975554

Signature of
Role Plan administrator
Date 2012-10-24
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature
CAMELOT RADIOLOGY ASSOCIATES, LTD. CASH BALANCE PLAN 2009 362667167 2012-06-20 CAMELOT RADIOLOGY ASSOCIATES, LTD. 1
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8153975554
Plan sponsor’s DBA name C/O NORTHERN ILLINOIS RADIOLOGY
Plan sponsor’s address 3849 N. PERRYVILLE ROAD, ROCKFORD, IL, 61114

Plan administrator’s name and address
Administrator’s EIN 362667167
Plan administrator’s name CAMELOT RADIOLOGY ASSOCIATES, LTD.
Plan administrator’s address 3849 N. PERRYVILLE ROAD, ROCKFORD, IL, 61114
Administrator’s telephone number 8153975554

Signature of
Role Plan administrator
Date 2012-06-19
Name of individual signing REBECCA STEMM
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JOHN D LANPHER, 2601 REID FARM ROAD SUITE B, ROCKFORD, 61114, WINNEBAGO Agent 2007-08-27

President

Name and Address Role
MARTIN URBAN MD, 3871 N PERRYVILLE RD, ROCKFORD 61114 President

Secretary

Name and Address Role
MARTIN URBAN MD, 3871 N PERRYVILLE RD, ROCKFORD 61114 Secretary

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
MEDICAL CORP 042000454 No data No data REGISTERED MEDICAL CORPORATION No data 1998-01-01 2022-05-05 2025-01-01

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
NORTHERN ILINOIS RADIOLOGISTS No data 2007-01-23 2015-10-01 Involuntary Cancellation No data
MAMMOGRAPHY CENTER No data 1993-10-08 2005-10-01 Involuntary Cancellation No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 333340 1

Related by officers

JOHN D LANPHER, 2601 REID FARM ROAD SUITE B, ROCKFORD, 61114, WINNEBAGO

GRUSUS, INC.

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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