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  5. VASANTHA KUMARAIAH, M.D., S.C.

VASANTHA KUMARAIAH, M.D., S.C.

Company Details

Entity Name: VASANTHA KUMARAIAH, M.D., S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 23 Apr 1982
Date of Dissolution: 08 Sep 2017
Company Number: CORP_52716306
File Number: 52716306
Date Status Change: 08 Sep 2017
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2017 363173182 2018-10-03 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 20209 OVERLAND TRAIL, OLYMPIA FIELDS, IL, 60461

Signature of
Role Plan administrator
Date 2018-10-03
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-03
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2016 363173182 2017-10-06 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 20209 OVERLAND TRAIL, OLYMPIA FIELDS, IL, 60461

Signature of
Role Plan administrator
Date 2017-10-06
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-06
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2015 363173182 2016-09-23 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477

Signature of
Role Plan administrator
Date 2016-09-23
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-23
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2014 363173182 2015-10-06 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477

Signature of
Role Plan administrator
Date 2015-10-06
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-06
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2013 363173182 2014-10-02 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477

Signature of
Role Plan administrator
Date 2014-10-02
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-02
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2012 363173182 2013-10-09 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-09
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2011 363173182 2012-10-11 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477

Plan administrator’s name and address
Administrator’s EIN 363173182
Plan administrator’s name VASANTHA KUMARAIAH, M.D., S.C.
Plan administrator’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477
Administrator’s telephone number 7085325500

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-11
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2010 363173182 2011-10-14 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477

Plan administrator’s name and address
Administrator’s EIN 363173182
Plan administrator’s name VASANTHA KUMARAIAH, M.D., S.C.
Plan administrator’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477
Administrator’s telephone number 7085325500

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-14
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2009 363173182 2010-10-14 VASANTHA KUMARAIAH, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477

Plan administrator’s name and address
Administrator’s EIN 363173182
Plan administrator’s name VASANTHA KUMARAIAH, M.D., S.C.
Plan administrator’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477
Administrator’s telephone number 7085325500

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with authorized/valid electronic signature
VASANTHA KUMARAIAH, M.D., S.C. PROFIT SHARING PLAN AND TRUST 2009 363173182 2010-10-14 VASANTHA KUMARAIAH, M.D., S.C. 2
Three-digit plan number (PN) 002
Effective date of plan 1987-05-01
Business code 621111
Sponsor’s telephone number 7085325500
Plan sponsor’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477

Plan administrator’s name and address
Administrator’s EIN 363173182
Plan administrator’s name VASANTHA KUMARAIAH, M.D., S.C.
Plan administrator’s address 17732 OAK PARK AVENUE, SUITE F, TINLEY PARK, IL, 60477
Administrator’s telephone number 7085325500

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing VASANTHA KUMARAIAH
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name and Address Role Appointment Date
EARL L SIMON, 4709 W GOLF ROAD, 475, SKOKIE, 60076, COOK-NOT IN CITY OF CHICAGO Agent 2006-01-20

President

Name and Address Role
VASANTHA KUMARAIAH MD, 17732 SOAK PARK AVE STE F TINLEY PK President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COM No data Voting Rights 10000 1000000 1

Related by officers

EARL L SIMON, 4709 W GOLF ROAD, 475, SKOKIE, 60076, COOK-NOT IN CITY OF CHICAGO

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Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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