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PRESENCE CARE TRANSFORMATION CORPORATION

Company Details

Entity Name: PRESENCE CARE TRANSFORMATION CORPORATION
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 10 Apr 1985
Company Number: CORP_53807984
File Number: 53807984
Type of Business: Religious
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROVENA HEALTH EMPLOYEE WELFARE PLAN 2012 363366652 2013-10-15 PROVENA HEALTH 8442
File View Page
Three-digit plan number (PN) 510
Effective date of plan 1999-01-01
Business code 622000
Sponsor’s telephone number 8158062325
Plan sponsor’s mailing address 18965 HICKORY CREEK DR., SUITE 300, MOKENA, IL, 60448
Plan sponsor’s address 18965 HICKORY CREEK DR., SUITE 300, MOKENA, IL, 60448

Number of participants as of the end of the plan year

Active participants 8324
Retired or separated participants receiving benefits 89
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2013-10-15
Name of individual signing MARY ANN NOLAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-15
Name of individual signing MARY ANN NOLAN
Valid signature Filed with authorized/valid electronic signature
PROVENA HEALTH EMPLOYEE WELFARE BENEFIT PROGRAM 2011 363366652 2012-10-15 PROVENA HEALTH 8394
File View Page
Three-digit plan number (PN) 510
Effective date of plan 1999-01-01
Business code 622000
Sponsor’s telephone number 7084786342
Plan sponsor’s mailing address 19065 HICKORY CREEK DRIVE, SUITE 300, MOKENA, IL, 60448
Plan sponsor’s address 19065 HICKORY CREEK DRIVE, SUITE 300, MOKENA, IL, 60448

Plan administrator’s name and address

Administrator’s EIN 363366652
Plan administrator’s name PROVENA HEALTH
Plan administrator’s address 19065 HICKORY CREEK DRIVE, SUITE 300, MOKENA, IL, 60448
Administrator’s telephone number 7084786342

Number of participants as of the end of the plan year

Active participants 8343
Retired or separated participants receiving benefits 99

Signature of

Role Plan administrator
Date 2012-10-15
Name of individual signing MARY ANN NOLAN
Valid signature Filed with authorized/valid electronic signature
PROVENA HEALTH EMPLOYEE WELFARE BENEFIT PROGRAM 2010 363366652 2011-10-14 PROVENA HEALTH 8394
File View Page
Three-digit plan number (PN) 510
Effective date of plan 1999-01-01
Business code 622000
Sponsor’s telephone number 7084786342
Plan sponsor’s mailing address 19065 HICKORY CREEK DRIVE, SUITE 300, MOKENA, IL, 60448
Plan sponsor’s address 19065 HICKORY CREEK DRIVE, SUITE 300, MOKENA, IL, 60448

Plan administrator’s name and address

Administrator’s EIN 363366652
Plan administrator’s name PROVENA HEALTH
Plan administrator’s address 19065 HICKORY CREEK DRIVE, MOKENA, IL, 60448
Administrator’s telephone number 7084786342

Number of participants as of the end of the plan year

Active participants 8403
Retired or separated participants receiving benefits 110

Signature of

Role Plan administrator
Date 2011-10-14
Name of individual signing MARY ANN NOLAN
Valid signature Filed with authorized/valid electronic signature
PROVENA HEALTH EMPLOYEE WELFARE BENEFIT PROGRAM 2009 363366652 2010-10-15 PROVENA HEALTH 8394
File View Page
Three-digit plan number (PN) 510
Effective date of plan 1999-01-01
Business code 622000
Sponsor’s telephone number 7084786333
Plan sponsor’s mailing address 19065 HICKORY CREEK DRIVE, MOKENA, IL, 60448
Plan sponsor’s address 19065 HICKORY CREEK DRIVE, MOKENA, IL, 60448

Plan administrator’s name and address

Administrator’s EIN 363366652
Plan administrator’s name PROVENA HEALTH
Plan administrator’s address 19065 HICKORY CREEK DRIVE, MOKENA, IL, 60448
Administrator’s telephone number 7084786333

Number of participants as of the end of the plan year

Active participants 8394
Retired or separated participants receiving benefits 135
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2010-10-15
Name of individual signing MARY ANN NOLAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
C T CORPORATION SYSTEM, 208 SO LASALLE ST, SUITE 814, CHICAGO, 60604, COOK-NOT IN CITY OF CHICAGO Agent 2018-03-02

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
SPEECH-LANGUAGE PATH 202000212 No data No data SPEECH LANGUAGE PATHOLOGY/AUDIOLOGY CE SPONSOR No data 2020-07-24 2020-07-24 2021-10-31

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
SACOR SYSTEMS, NFP No data 2002-08-16 2010-06-02 Expired No data
SACOR SYSTEMS COLLECTION AGENCY, NFP No data 2002-03-12 2010-06-02 Expired No data
SACOR SYSTEMS COLLECTION AGENCY No data 1998-12-04 2000-09-01 Involuntary Cancellation No data

Historical Names

Name Change Date
PRESENCE PRV HEALTH 2016-01-01
PROVENA HEALTH 2012-10-01
MERCY HEALTH CORPORATION 1997-11-30

Date of last update: 23 Jan 2025

Sources: Illinois Office of the Secretary of State