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  5. JEFFREY S. WAITZMAN, M.D., S.C.

JEFFREY S. WAITZMAN, M.D., S.C.

Company Details

Entity Name: JEFFREY S. WAITZMAN, M.D., S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 23 Sep 1986
Date of Dissolution: 08 Feb 2013
Company Number: CORP_54388594
File Number: 54388594
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 08 Feb 2013
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JEFFREY S. WAITZMAN, M.D., S.C. EMPLOYEES' PROFIT SHARING PLAN & TRUST 2011 363463288 2012-08-01 JEFFREY S. WAITZMAN, M.D., S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8477191300
Plan sponsor’s address 183 OAKMONT DRIVE, DEERFIELD, IL, 60015

Plan administrator’s name and address
Administrator’s EIN 363463288
Plan administrator’s name JEFFREY S. WAITZMAN, M.D., S.C.
Plan administrator’s address 183 OAKMONT DRIVE, DEERFIELD, IL, 60015
Administrator’s telephone number 8477191300

Signature of
Role Plan administrator
Date 2012-08-01
Name of individual signing JEFFREY S. WAITZMAN, M.D.
Valid signature Filed with authorized/valid electronic signature
JEFFREY S. WAITZMAN, M.D., S.C. EMPLOYEES' PROFIT SHARING PLAN & TRUST 2010 363463288 2011-06-16 JEFFREY S. WAITZMAN, M.D., S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8477191300
Plan sponsor’s address C/O LAW OFFICES OF GARY R. WAITZMAN, 250 PARKWAY DRIVE, SUITE 130, LINCOLNSHIRE, IL, 60069

Plan administrator’s name and address
Administrator’s EIN 363463288
Plan administrator’s name JEFFREY S. WAITZMAN, M.D., S.C.
Plan administrator’s address C/O LAW OFFICES OF GARY R. WAITZMAN, 250 PARKWAY DRIVE, SUITE 130, LINCOLNSHIRE, IL, 60069
Administrator’s telephone number 8477191300

Signature of
Role Plan administrator
Date 2011-06-16
Name of individual signing JEFFREY S. WAITZMAN, M.D.
Valid signature Filed with authorized/valid electronic signature
JEFFREY S. WAITZMAN, M.D., S.C. EMPLOYEES' PROFIT SHARING PLAN & TRUST 2009 363463288 2010-09-30 JEFFREY S. WAITZMAN, M.D., S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8476980400
Plan sponsor’s address 1875 DEMPSTER STREET, SUITE 265, PARK RIDGE, IL, 60068

Plan administrator’s name and address
Administrator’s EIN 363463288
Plan administrator’s name JEFFREY S. WAITZMAN, M.D., S.C.
Plan administrator’s address 1875 DEMPSTER STREET, SUITE 265, PARK RIDGE, IL, 60068
Administrator’s telephone number 8476980400

Signature of
Role Plan administrator
Date 2010-09-30
Name of individual signing JEFFREY S. WAITZMAN, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
GARY R WAITZMAN, 250 PARKWAY DR STE 130, LINCOLNSHIRE, 60069, LAKE Agent 2008-07-29

President

Name and Address Role
JEFFERY S WAITZMAN, 1875 DEMPSTER ST PARK RIDGE IL 60068 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100000 1000000 No data

Related by officers

GARY R WAITZMAN, 250 PARKWAY DR STE 130, LINCOLNSHIRE, 60069, LAKE

MORA, BAUGH, WAITZMAN & UNGER, L.L.C. ANDERSON PERLSTEIN, LTD. LAW OFFICES OF GARY R WAITZMAN, L.L.C. CARDIAC TECHNOLOGIES, INC. WILLIAMS ROOFING & GUTTERS, INC.

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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