| Entity Name: | CRUSADERS CENTRAL CLINIC ASSOCIATION |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Not-for-Profit |
| Status: | Goodstanding |
| Date Formed: | 29 Jun 1970 |
| Company Number: | CORP_49683421 |
| File Number: | 49683421 |
| Place of Formation: | ILLINOIS |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| MNZVCQMM4E77 | 2024-08-09 | 1200 W STATE ST, ROCKFORD, IL, 61102, 2112, USA | 1200 WEST STATE STREET, ROCKFORD, IL, 61102, 2112, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| URL | www.crusaderhealth.org |
| Division Name | CRUSADER CENTRAL CLINIC ASSOCIATION |
| Congressional District | 17 |
| State/Country of Incorporation | IL, USA |
| Activation Date | 2023-08-14 |
| Initial Registration Date | 2006-01-25 |
| Entity Start Date | 1972-01-01 |
| Fiscal Year End Close Date | Jun 30 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | LUIS DELGADO |
| Role | VP OF FINANCE |
| Address | 1200 WEST STATE STREET, ROCKFORD, IL, 61102, 2112, USA |
| Title | ALTERNATE POC |
| Name | SAMUEL MILLER |
| Address | 1200 WEST STATE STREET, ROCKFORD, IL, 61102, 2112, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | SAMUEL MILLER |
| Role | PRESIDENT & CEO |
| Address | 1200 WEST STATE STREET, ROCKFORD, IL, 61102, 2112, USA |
| Title | ALTERNATE POC |
| Name | SAMUEL MILLER |
| Address | 1200 WEST STATE STREET, ROCKFORD, IL, 61102, 2112, USA |
| Past Performance | |
|---|---|
| Title | PRIMARY POC |
| Name | PEGGYANNE DAVENPORT |
| Address | 1200 WEST STATE STREET, ROCKFORD, IL, 61102, USA |
| Title | ALTERNATE POC |
| Name | PEGGYANNE DAVENPORT |
| Address | 1200 WEST STATE STREET, ROCKFORD, IL, 61102, USA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CRUSADER COMMUNITY HEALTH EMPLOYEE BENEFIT PLAN | 2023 | 237076080 | 2024-11-08 | CRUSADER COMMUNITY HEALTH | 428 | |||||||||||||||||||||
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| Active participants | 434 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| SAMUEL G MILLER, 1200 W STATE ST, ROCKFORD, 61102, WINNEBAGO | Agent | 2019-12-18 |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| CRUSADER COMMUNITY HEALTH | NFP Assume Name | 2008-10-08 | No data | No data | No data |
Date of last update: 13 Jan 2025
