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  5. ST. CHARLES FAMILY MEDICAL CENTER, S.C.

ST. CHARLES FAMILY MEDICAL CENTER, S.C.

Headquarter

Company Details

Entity Name: ST. CHARLES FAMILY MEDICAL CENTER, S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 10 Apr 1981
Date of Dissolution: 13 Sep 2019
Company Number: CORP_52356237
File Number: 52356237
Date Status Change: 13 Sep 2019
Place of Formation: ILLINOIS

Links between entities

Type Company Name Company Number State
Headquarter of ST. CHARLES FAMILY MEDICAL CENTER, S.C., NEW YORK 1420755 NEW YORK

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2018 371096782 2019-05-21 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2018 371096782 2019-05-31 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2017 371096782 2018-10-02 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2016 371096782 2017-06-14 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2015 371096782 2016-08-12 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2014 371096782 2015-10-13 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing AMY FITZGERALD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-12
Name of individual signing AMY FITZGERALD
Valid signature Filed with authorized/valid electronic signature
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2013 371096782 2014-07-03 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174

Signature of
Role Plan administrator
Date 2014-07-03
Name of individual signing AMY FITZGERALD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-03
Name of individual signing AMY FITZGERALD
Valid signature Filed with authorized/valid electronic signature
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2012 371096782 2013-08-30 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174

Signature of
Role Plan administrator
Date 2013-08-30
Name of individual signing AMY FITZGERALD
Valid signature Filed with authorized/valid electronic signature
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2011 371096782 2012-10-11 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174

Plan administrator’s name and address
Administrator’s EIN 371096782
Plan administrator’s name ST. CHARLES FAMILY MEDICAL CENTER, S.C.
Plan administrator’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174
Administrator’s telephone number 6303772800

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing AMY FITZGERALD
Valid signature Filed with authorized/valid electronic signature
ST. CHARLES FAMILY MEDICAL CENTER, S.C. 401(K) PROFIT SHARING PLAN 2010 371096782 2011-09-08 ST. CHARLES FAMILY MEDICAL CENTER, S.C. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-01
Business code 621111
Sponsor’s telephone number 6303772800
Plan sponsor’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174

Plan administrator’s name and address
Administrator’s EIN 371096782
Plan administrator’s name ST. CHARLES FAMILY MEDICAL CENTER, S.C.
Plan administrator’s address 110 SOUTH 17TH STREET, ST. CHARLES, IL, 60174
Administrator’s telephone number 6303772800

Signature of
Role Plan administrator
Date 2011-09-08
Name of individual signing AMY FITZGERALD
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
WILLIAM B SCURLOCK, 110 S 17TH STREET, ST CHARLES, 60174, KANE Agent 1995-04-18

President

Name and Address Role
WILLIAM B SCURLOCK, 110 S 17TH ST., ST CHARLES, IL, 60174 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Rights Unknown 100000 1500000 No data

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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