| Entity Name: | 3900 W GRENSHAW BLOCK CLUB |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Not-for-Profit |
| Status: | Dissolved |
| Date Formed: | 15 Jan 1986 |
| Date of Dissolution: | 01 Jun 2002 |
| Company Number: | CORP_54115016 |
| File Number: | 54115016 |
| Type of Business: | Not for Profit |
| Date Status Change: | 01 Jun 2002 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SURGEONS OF LAKE COUNTY LLC 401(K) RETIREMENT PLAN | 2011 | 260882765 | 2013-06-06 | SURGEONS OF LAKE COUNTY LLC | 9 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 260882765 |
| Plan administrator’s name | SURGEONS OF LAKE COUNTY LLC |
| Plan administrator’s address | 1870 W. WINCHESTER RD., SUITE 112, LIBERTYVILLE, IL, 60048 |
| Administrator’s telephone number | 8478167495 |
Signature of
| Role | Plan administrator |
| Date | 2013-06-05 |
| Name of individual signing | CHERYL OTTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-06-05 |
| Name of individual signing | CHERYL OTTO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-10-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8478167495 |
| Plan sponsor’s address | 1870 W. WINCHESTER RD., SUITE 112, LIBERTYVILLE, IL, 60048 |
Plan administrator’s name and address
| Administrator’s EIN | 260882765 |
| Plan administrator’s name | SURGEONS OF LAKE COUNTY LLC |
| Plan administrator’s address | 1870 W. WINCHESTER RD., SUITE 112, LIBERTYVILLE, IL, 60048 |
| Administrator’s telephone number | 8478167495 |
Signature of
| Role | Plan administrator |
| Date | 2012-02-03 |
| Name of individual signing | SCOTT OTTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-02-03 |
| Name of individual signing | SCOTT OTTO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-10-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8478167495 |
| Plan sponsor’s address | 1870 W. WINCHESTER RD., SUITE 112, LIBERTYVILLE, IL, 60048 |
Plan administrator’s name and address
| Administrator’s EIN | 260882765 |
| Plan administrator’s name | SURGEONS OF LAKE COUNTY LLC |
| Plan administrator’s address | 1870 W. WINCHESTER RD., SUITE 112, LIBERTYVILLE, IL, 60048 |
| Administrator’s telephone number | 8478167495 |
Signature of
| Role | Plan administrator |
| Date | 2011-04-18 |
| Name of individual signing | SCOTT C OTTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-04-18 |
| Name of individual signing | SCOTT C OTTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| MARIAN ADAMS, 3947 W GRENSHAW, CHICAGO, 60624, COOK-NOT IN CITY OF CHICAGO | Agent | 1986-01-15 |
Date of last update: 13 Jan 2025
