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  5. PROVIDENCE-ST. MEL SCHOOL

PROVIDENCE-ST. MEL SCHOOL

Company Details

Entity Name: PROVIDENCE-ST. MEL SCHOOL
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 31 May 1978
Company Number: CORP_51462858
File Number: 51462858
Address 119 S CENTRAL PARK BLVD, CHICAGO, IL, 60624
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2022 362977187 2024-02-27 PROVIDENCE ST. MEL SCHOOL 106
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2021 362977187 2023-01-28 PROVIDENCE ST. MEL SCHOOL 97
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2020 362977187 2021-11-11 PROVIDENCE ST. MEL SCHOOL 97
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624

Signature of
Role Plan administrator
Date 2021-11-11
Name of individual signing PAUL ADAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-11-11
Name of individual signing JEANETTE BUTALA
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2019 362977187 2021-01-26 PROVIDENCE ST. MEL SCHOOL 94
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624

Signature of
Role Plan administrator
Date 2021-01-26
Name of individual signing PAUL ADAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-01-19
Name of individual signing JEANETTE BUTALA
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2018 362977187 2020-02-14 PROVIDENCE ST. MEL SCHOOL 91
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624

Signature of
Role Plan administrator
Date 2020-02-14
Name of individual signing PAUL ADAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-02-14
Name of individual signing MICHAEL BROGAN
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2017 362977187 2019-02-11 PROVIDENCE ST. MEL SCHOOL 92
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624

Signature of
Role Plan administrator
Date 2019-02-11
Name of individual signing ANA MARTINEZ
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2016 362977187 2018-03-21 PROVIDENCE ST. MEL SCHOOL 90
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624

Signature of
Role Plan administrator
Date 2018-03-21
Name of individual signing ANA MARTINEZ
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2015 362977187 2017-01-25 PROVIDENCE ST. MEL SCHOOL 94
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624

Signature of
Role Plan administrator
Date 2017-01-25
Name of individual signing ALISA SEMEGEN
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2014 362977187 2016-04-06 PROVIDENCE ST. MEL SCHOOL 89
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624

Signature of
Role Plan administrator
Date 2016-04-06
Name of individual signing ALISA SEMEGEN
Valid signature Filed with authorized/valid electronic signature
PROVIDENCE ST. MEL SCHOOL 403(B) TDA PLAN 2013 362977187 2015-04-09 PROVIDENCE ST. MEL SCHOOL 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-09-01
Business code 611000
Sponsor’s telephone number 7737224600
Plan sponsor’s address 119 S. CENTRAL PARK BLVD., CHICAGO, IL, 60624

Signature of
Role Plan administrator
Date 2015-04-09
Name of individual signing ALISA SEMEGEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
PAUL J ADAMS III, 119 SOUTH CENTRAL PARK BLVD, CHICAGO, 60624, COOK-NOT IN CITY OF CHICAGO Agent 2007-09-13

Inspection

Inspection ID Inspection Type Inspection Date License Facility Type Address Risk Results
2607414 Canvass 2024-11-14 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Pass
2572334 Canvass 2023-03-10 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Pass
2553035 Canvass 2022-03-17 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Pass
2545447 Canvass Re-Inspection 2021-12-13 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Fail
2545293 Canvass 2021-12-09 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Fail
2311735 Canvass 2019-09-04 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Pass
2240806 Canvass 2018-11-29 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Pass
2104936 Canvass 2017-11-17 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Pass
1975770 Canvass 2016-11-21 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Pass
1575559 Canvass 2015-09-15 2040661 School 119 S CENTRAL PARK AVE, CHICAGO, IL, 60624 Risk 3 (Low) Pass

Historical Names

Name Change Date
PROVIDENCE - ST. MEL HIGH SCHOOL 1996-09-10

Related by officers

No related officers

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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