NORTH SUBURBAN PEDIATRICS, S.C. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2011
|
362659757
|
2013-07-12
|
NORTH SUBURBAN PEDIATRICS, S.C.
|
41
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1968-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
8478690892
|
Plan sponsor’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201
|
Plan administrator’s name and address
Administrator’s EIN |
362659757 |
Plan administrator’s name |
NORTH SUBURBAN PEDIATRICS, S.C. |
Plan administrator’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201 |
Administrator’s telephone number |
8478690892 |
Signature of
Role |
Plan administrator |
Date |
2013-07-12 |
Name of individual signing |
VIRGINIA M. DEPAUL, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTH SUBURBAN PEDIATRICS, S.C. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2011
|
362659757
|
2013-06-28
|
NORTH SUBURBAN PEDIATRICS, S.C.
|
No data
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1968-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
8478690892
|
Plan sponsor’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201
|
Plan administrator’s name and address
Administrator’s EIN |
362659757 |
Plan administrator’s name |
NORTH SUBURBAN PEDIATRICS, S.C. |
Plan administrator’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201 |
Administrator’s telephone number |
8478690892 |
Signature of
Role |
Plan administrator |
Date |
2013-06-28 |
Name of individual signing |
VIRGINIA M. DEPAUL, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTH SUBURBAN PEDIATRICS, S.C. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2010
|
362659757
|
2012-05-09
|
NORTH SUBURBAN PEDIATRICS, S.C.
|
42
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1968-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
8478690892
|
Plan sponsor’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201
|
Plan administrator’s name and address
Administrator’s EIN |
362659757 |
Plan administrator’s name |
NORTH SUBURBAN PEDIATRICS, S.C. |
Plan administrator’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201 |
Administrator’s telephone number |
8478690892 |
Signature of
Role |
Plan administrator |
Date |
2012-05-09 |
Name of individual signing |
VIRGINIA M. DEPAUL, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTH SUBURBAN PEDIATRICS, S.C. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2009
|
362659757
|
2011-09-27
|
NORTH SUBURBAN PEDIATRICS, S.C.
|
43
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1968-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
8478690892
|
Plan sponsor’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201
|
Plan administrator’s name and address
Administrator’s EIN |
362659757 |
Plan administrator’s name |
NORTH SUBURBAN PEDIATRICS, S.C. |
Plan administrator’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201 |
Administrator’s telephone number |
8478690892 |
Signature of
Role |
Plan administrator |
Date |
2011-09-27 |
Name of individual signing |
VIRGINIA M. DEPAUL |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
NORTH SUBURBAN PEDIATRICS, S.C. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2009
|
362659757
|
2011-09-27
|
NORTH SUBURBAN PEDIATRICS, S.C.
|
43
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1968-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
8478690892
|
Plan sponsor’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201
|
Plan administrator’s name and address
Administrator’s EIN |
362659757 |
Plan administrator’s name |
NORTH SUBURBAN PEDIATRICS, S.C. |
Plan administrator’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201 |
Administrator’s telephone number |
8478690892 |
Signature of
Role |
Plan administrator |
Date |
2011-09-27 |
Name of individual signing |
KELLY KIRSCHBAUM |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
NORTH SUBURBAN PEDIATRICS, S.C. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2009
|
362659757
|
2011-09-27
|
NORTH SUBURBAN PEDIATRICS, S.C.
|
43
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1968-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
8478690892
|
Plan sponsor’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201
|
Plan administrator’s name and address
Administrator’s EIN |
362659757 |
Plan administrator’s name |
NORTH SUBURBAN PEDIATRICS, S.C. |
Plan administrator’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201 |
Administrator’s telephone number |
8478690892 |
Signature of
Role |
Plan administrator |
Date |
2011-09-27 |
Name of individual signing |
VIRGINIA DEPAUL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTH SUBURBAN PEDIATRICS, S.C. PROFIT-SHARING AND SAVINGS PLAN AND TRUST
|
2009
|
362659757
|
2011-07-12
|
NORTH SUBURBAN PEDIATRICS, S.C.
|
43
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1968-11-01
|
Business code |
621111
|
Sponsor’s telephone number |
8478690892
|
Plan sponsor’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201
|
Plan administrator’s name and address
Administrator’s EIN |
362659757 |
Plan administrator’s name |
NORTH SUBURBAN PEDIATRICS, S.C. |
Plan administrator’s
address |
2530 RIDGE AVE., EVANSTON, IL, 60201 |
Administrator’s telephone number |
8478690892 |
Signature of
Role |
Plan administrator |
Date |
2011-07-12 |
Name of individual signing |
KELLY KIRSCHBAUM |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-12 |
Name of individual signing |
VIGINIA M. DEPAUL |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|