LAKE FOREST PEDIATRIC ASSOCIATES, LTD. PROFIT SHARING PLAN AND TRUST
|
2012
|
362671870
|
2013-06-24
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD.
|
95
|
|
File |
View Page
|
Three-digit plan number (PN) |
010
|
Effective date of plan |
1988-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472951220
|
Plan sponsor’s
address |
917 SHERWOOD DRIVE, FIRST FLOOR, LAKE BLUFF, IL, 60044
|
Signature of
Role |
Plan administrator |
Date |
2013-06-24 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. PROFIT SHARING PLAN AND TRUST
|
2011
|
362671870
|
2012-08-29
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD.
|
99
|
|
File |
View Page
|
Three-digit plan number (PN) |
010
|
Effective date of plan |
1988-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472951220
|
Plan sponsor’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045
|
Plan administrator’s name and address
Administrator’s EIN |
362671870 |
Plan administrator’s name |
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. |
Plan administrator’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045 |
Administrator’s telephone number |
8472951220 |
Signature of
Role |
Plan administrator |
Date |
2012-08-29 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-08-29 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. PROFIT SHARING PLAN AND TRUST
|
2010
|
362671870
|
2011-07-26
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD.
|
95
|
|
File |
View Page
|
Three-digit plan number (PN) |
010
|
Effective date of plan |
1988-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472951220
|
Plan sponsor’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045
|
Plan administrator’s name and address
Administrator’s EIN |
362671870 |
Plan administrator’s name |
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. |
Plan administrator’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045 |
Administrator’s telephone number |
8472951220 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-26 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. PROFIT SHARING PLAN AND TRUST
|
2009
|
362671870
|
2010-09-08
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD.
|
94
|
|
Three-digit plan number (PN) |
010
|
Effective date of plan |
1988-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472951220
|
Plan sponsor’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045
|
Plan administrator’s name and address
Administrator’s EIN |
362671870 |
Plan administrator’s name |
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. |
Plan administrator’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045 |
Administrator’s telephone number |
8472951220 |
Signature of
Role |
Plan administrator |
Date |
2010-09-08 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-09-08 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. PROFIT SHARING PLAN AND TRUST
|
2009
|
362671870
|
2010-09-08
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD.
|
94
|
|
Three-digit plan number (PN) |
010
|
Effective date of plan |
1988-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472951220
|
Plan sponsor’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045
|
Plan administrator’s name and address
Administrator’s EIN |
362671870 |
Plan administrator’s name |
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. |
Plan administrator’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045 |
Administrator’s telephone number |
8472951220 |
Signature of
Role |
Plan administrator |
Date |
2010-09-08 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. PROFIT SHARING PLAN AND TRUST
|
2009
|
362671870
|
2010-09-13
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD.
|
94
|
|
File |
View Page
|
Three-digit plan number (PN) |
010
|
Effective date of plan |
1988-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472951220
|
Plan sponsor’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045
|
Plan administrator’s name and address
Administrator’s EIN |
362671870 |
Plan administrator’s name |
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. |
Plan administrator’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045 |
Administrator’s telephone number |
8472951220 |
Signature of
Role |
Plan administrator |
Date |
2010-09-13 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-09-13 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. PROFIT SHARING PLAN AND TRUST
|
2009
|
362671870
|
2010-09-07
|
LAKE FOREST PEDIATRIC ASSOCIATES, LTD.
|
94
|
|
Three-digit plan number (PN) |
010
|
Effective date of plan |
1988-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8472951220
|
Plan sponsor’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045
|
Plan administrator’s name and address
Administrator’s EIN |
362671870 |
Plan administrator’s name |
LAKE FOREST PEDIATRIC ASSOCIATES, LTD. |
Plan administrator’s
address |
900 N. WESTMORELAND RD. SUITE 110, LAKE FOREST, IL, 60045 |
Administrator’s telephone number |
8472951220 |
Signature of
Role |
Plan administrator |
Date |
2010-09-07 |
Name of individual signing |
BERNARD B. PRITZKER, M.D. |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|