| Entity Name: | THOMAS A. WROBLEWSKI, M.D. S.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 01 Feb 1991 |
| Date of Dissolution: | 10 Jul 2015 |
| Company Number: | CORP_56265546 |
| File Number: | 56265546 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Date Status Change: | 10 Jul 2015 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS A. WROBLEWSKI, M.D. S.C. 401(K) PROFIT SHARING PLAN | 2011 | 363745697 | 2013-02-27 | THOMAS A. WROBLEWSKI, M.D. S.C. | 10 | |||||||||||||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 363745697 |
| Plan administrator’s name | THOMAS A. WROBLEWSKI, M.D. S.C. |
| Plan administrator’s address | 401 N. WALL STREET, SUITE 102, KANKAKEE, IL, 60901 |
| Administrator’s telephone number | 8159374404 |
Signature of
| Role | Plan administrator |
| Date | 2013-02-27 |
| Name of individual signing | THOMAS WROBLEWSKI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-02-27 |
| Name of individual signing | THOMAS WROBLEWSKI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2010-11-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8159374404 |
| Plan sponsor’s address | 401 N. WALL STREET, SUITE 102, KANKAKEE, IL, 60901 |
Plan administrator’s name and address
| Administrator’s EIN | 363745697 |
| Plan administrator’s name | THOMAS A. WROBLEWSKI, M.D. S.C. |
| Plan administrator’s address | 401 N. WALL STREET, SUITE 102, KANKAKEE, IL, 60901 |
| Administrator’s telephone number | 8159374404 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-23 |
| Name of individual signing | THOMAS A. WROBLEWSKI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-05-23 |
| Name of individual signing | THOMAS A. WROBLEWSKI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| THOMAS A WROBLEWSKI, 401 N WALL STREET STE 102, KANKAKEE, 60901, KANKAKEE | Agent | 2002-03-07 |
| Name and Address | Role |
|---|---|
| THOMAS A WROBLEWSKI 401 N WALL ST STE 102 KANKAKEE 60901 | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMM | No data | Voting Rights | 5000 | 1000000 | 1 |
Date of last update: 16 Jan 2025
