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  5. HORIZON HOSPICE & PALLIATIVE CARE, INC.

HORIZON HOSPICE & PALLIATIVE CARE, INC.

Company Details

Entity Name: HORIZON HOSPICE & PALLIATIVE CARE, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Merged/Consolidated
Date Formed: 11 Apr 1978
Company Number: CORP_51417321
File Number: 51417321
Date Status Change: 01 Jun 2015
Address 833 W CHICAGO AVE, CHICAGO, IL, 60642
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HORIZON HOSPICE INC 403B PENSION PLAN 2010 362972550 2011-07-18 HORIZON HOSPICE & PALLIATIVE CARE, INC 73
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s address 833 W CHICAGO AVENUE, CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC
Plan administrator’s address 833 W CHICAGO AVENUE, CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2011-07-14
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC 403B PENSION PLAN 2009 362972550 2010-09-07 HORIZON HOSPICE & PALLIATIVE CARE, INC 52
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s address 833 W CHICAGO AVENUE, CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC
Plan administrator’s address 833 W CHICAGO AVENUE, CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-03
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC. 403(B) PENSION PLAN 2009 362972550 2010-09-02 HORIZON HOSPICE & PALLIATIVE CARE INC. No data
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s mailing address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Plan sponsor’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC.
Plan administrator’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC. 403(B) PENSION PLAN 2009 362972550 2010-09-02 HORIZON HOSPICE & PALLIATIVE CARE INC. No data
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s mailing address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Plan sponsor’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC.
Plan administrator’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC. 403(B) PENSION PLAN 2009 362972550 2010-09-02 HORIZON HOSPICE & PALLIATIVE CARE INC. No data
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s mailing address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Plan sponsor’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC.
Plan administrator’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC. 403(B) PENSION PLAN 2009 362972550 2010-09-02 HORIZON HOSPICE & PALLIATIVE CARE INC. No data
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s mailing address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Plan sponsor’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC.
Plan administrator’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC. 403(B) PENSION PLAN 2009 362972550 2010-09-02 HORIZON HOSPICE & PALLIATIVE CARE INC. No data
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s mailing address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Plan sponsor’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC.
Plan administrator’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC. 403(B) PENSION PLAN 2009 362972550 2010-09-02 HORIZON HOSPICE & PALLIATIVE CARE INC. No data
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s mailing address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Plan sponsor’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC.
Plan administrator’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC. 403(B) PENSION PLAN 2009 362972550 2010-09-02 HORIZON HOSPICE & PALLIATIVE CARE INC. No data
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s mailing address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Plan sponsor’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC.
Plan administrator’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature
HORIZON HOSPICE INC. 403(B) PENSION PLAN 2009 362972550 2010-09-02 HORIZON HOSPICE & PALLIATIVE CARE INC. No data
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621900
Sponsor’s telephone number 3127332233
Plan sponsor’s mailing address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Plan sponsor’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622

Plan administrator’s name and address
Administrator’s EIN 362972550
Plan administrator’s name HORIZON HOSPICE & PALLIATIVE CARE INC.
Plan administrator’s address 833 W. CHICAGO AVE., CHICAGO, IL, 60622
Administrator’s telephone number 3127332233

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing MICHAEL KOLBUK
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MARY G RUNGE, 833 W CHICAGO AVENUE STE 300, CHICAGO, 60642, COOK-NOT IN CITY OF CHICAGO Agent 2011-03-15

Director

Name and Address Role Account Number
DAVID C. HANOLD Director 219034

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
ADV PRACTICE NURSE 236000100 No data No data NURSE CE SPONSOR No data 2014-11-13 2014-11-13 2016-05-31
BUSINESS LICENSE 1171195 Issued 1625 Raffles 720 - Not-For-Profit Selling Raffles for Prizes of $50 or More 2014-09-24 2014-11-16 2015-11-15
SOCIAL WORKER 159001274 No data No data REGISTERED SOCIAL WORKER CE SPONSOR No data 2014-07-24 2014-07-24 2015-11-30

Historical Names

Name Change Date
HORIZON HOSPICE, INC. 2005-01-21

Related by officers

No related officers

Related by address

833 W CHICAGO AVE, CHICAGO, IL, 60642

SKYLINE CAPITAL GROUP, INC. SPICE RESTAURANT, INC.

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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