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  5. ZION CLINIC, S.C.

ZION CLINIC, S.C.

Company Details

Entity Name: ZION CLINIC, S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 27 Oct 1971
Date of Dissolution: 13 Mar 2015
Company Number: CORP_49914296
File Number: 49914296
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 13 Mar 2015
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ZION CLINIC, S.C. RESTATED PROFIT-SHARING PLAN & TRUST 2012 362721486 2014-08-12 ZION CLINIC, S.C. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1971-11-01
Business code 621111
Sponsor’s telephone number 8477463752
Plan sponsor’s address 3115 LEWIS AVE, ZION, IL, 600993099

Plan administrator’s name and address
Administrator’s EIN 362721486
Plan administrator’s name ZION CLINIC, S.C.
Plan administrator’s address 3115 LEWIS AVE, ZION, IL, 600993099
Administrator’s telephone number 8477463752

Signature of
Role Plan administrator
Date 2014-08-12
Name of individual signing C. DAVID ENGSTROM, M.D.
Valid signature Filed with authorized/valid electronic signature
ZION CLINIC, S.C. RESTATED PROFIT-SHARING PLAN & TRUST 2011 362721486 2013-07-10 ZION CLINIC, S.C. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1971-11-01
Business code 621111
Sponsor’s telephone number 8477463752
Plan sponsor’s address 3115 LEWIS AVE, ZION, IL, 600993099

Plan administrator’s name and address
Administrator’s EIN 362721486
Plan administrator’s name ZION CLINIC, S.C.
Plan administrator’s address 3115 LEWIS AVE, ZION, IL, 600993099
Administrator’s telephone number 8477463752

Signature of
Role Plan administrator
Date 2013-07-10
Name of individual signing C. DAVID ENGSTROM, M.D.
Valid signature Filed with authorized/valid electronic signature
ZION CLINIC, S.C. RESTATED PROFIT-SHARING PLAN & TRUST 2010 362721486 2012-08-08 ZION CLINIC, S.C. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1971-11-01
Business code 621111
Sponsor’s telephone number 8477463752
Plan sponsor’s address 3115 LEWIS AVE, ZION, IL, 600993099

Plan administrator’s name and address
Administrator’s EIN 362721486
Plan administrator’s name ZION CLINIC, S.C.
Plan administrator’s address 3115 LEWIS AVE, ZION, IL, 600993099
Administrator’s telephone number 8477463752

Signature of
Role Plan administrator
Date 2012-08-08
Name of individual signing C. DAVID ENGSTROM, M.D.
Valid signature Filed with authorized/valid electronic signature
ZION CLINIC, S.C. RESTATED PROFIT-SHARING PLAN & TRUST 2009 362721486 2011-07-22 ZION CLINIC, S.C. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1971-11-01
Business code 621111
Sponsor’s telephone number 8477463752
Plan sponsor’s address 3115 LEWIS AVE, ZION, IL, 600993099

Plan administrator’s name and address
Administrator’s EIN 362721486
Plan administrator’s name ZION CLINIC, S.C.
Plan administrator’s address 3115 LEWIS AVE, ZION, IL, 600993099
Administrator’s telephone number 8477463752

Signature of
Role Plan administrator
Date 2011-07-22
Name of individual signing C. DAVID ENGSTROM, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
C DAVID ENGSTROM, 3115 LEWIS AVE, ZION, 60099, LAKE Agent 2000-04-25

President

Name and Address Role
C DAVID ENGSTROM, 3115 LEWIS AVE ZION IL 60099 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 5000 1000000 No data

Related by officers

C DAVID ENGSTROM, 3115 LEWIS AVE, ZION, 60099, LAKE

ADEW MAINTENANCE CORP.

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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