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  5. ELK GROVE LAB PHYSICIANS, P.C.

ELK GROVE LAB PHYSICIANS, P.C.

Company Details

Entity Name: ELK GROVE LAB PHYSICIANS, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 24 Jun 1991
Date of Dissolution: 14 Nov 2014
Company Number: CORP_56439196
File Number: 56439196
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 14 Nov 2014
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ELK GROVE LAB PHYSICIANS, P.C. CASH BALANCE PENSION PLAN 2010 363775529 2011-07-12 ELK GROVE LAB PHYSICIANS, P.C. 5
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2007-01-01
Business code 621510
Sponsor’s telephone number 8475097331
Plan sponsor’s address C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 400, NORTHBROOK, IL, 60062

Plan administrator’s name and address
Administrator’s EIN 363775529
Plan administrator’s name ELK GROVE LAB PHYSICIANS, P.C.
Plan administrator’s address 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
Administrator’s telephone number 8475097331

Signature of
Role Plan administrator
Date 2011-07-12
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-12
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
ELK GROVE LAB PHYSICIANS, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2010 363775529 2011-07-13 ELK GROVE LAB PHYSICIANS, P.C. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621510
Sponsor’s telephone number 8475097331
Plan sponsor’s address C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062

Plan administrator’s name and address
Administrator’s EIN 363775529
Plan administrator’s name ELK GROVE LAB PHYSICIANS, P.C.
Plan administrator’s address C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
Administrator’s telephone number 8475097331

Signature of
Role Plan administrator
Date 2011-07-13
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-13
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
ELK GROVE LAB PHYSICIANS, P.C. CASH BALANCE PENSION PLAN 2009 363775529 2010-09-28 ELK GROVE LAB PHYSICIANS, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2007-01-01
Business code 621510
Sponsor’s telephone number 8475097331
Plan sponsor’s address C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062

Plan administrator’s name and address
Administrator’s EIN 363775529
Plan administrator’s name ELK GROVE LAB PHYSICIANS, P.C.
Plan administrator’s address 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
Administrator’s telephone number 8475097331

Signature of
Role Plan administrator
Date 2010-09-28
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-28
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
ELK GROVE LAB PHYSICIANS, P.C. CASH BALANCE PENSION PLAN 2009 363775529 2010-09-28 ELK GROVE LAB PHYSICIANS, P.C. 4
Three-digit plan number (PN) 004
Effective date of plan 2007-01-01
Business code 621510
Sponsor’s telephone number 8475097331
Plan sponsor’s address C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062

Plan administrator’s name and address
Administrator’s EIN 363775529
Plan administrator’s name ELK GROVE LAB PHYSICIANS, P.C.
Plan administrator’s address 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
Administrator’s telephone number 8475097331

Signature of
Role Plan administrator
Date 2010-09-28
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-28
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
ELK GROVE LAB PHYSICIANS, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2009 363775529 2010-09-27 ELK GROVE LAB PHYSICIANS, P.C. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621510
Sponsor’s telephone number 8475097331
Plan sponsor’s address C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062

Plan administrator’s name and address
Administrator’s EIN 363775529
Plan administrator’s name ELK GROVE LAB PHYSICIANS, P.C.
Plan administrator’s address C/O STEINBERG ADVISORS, LTD., 5 REVERE DRIVE, SUITE 120, NORTHBROOK, IL, 60062
Administrator’s telephone number 8475097331

Signature of
Role Plan administrator
Date 2010-09-27
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-27
Name of individual signing CARLOS SHIBATA, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MATTHEW YETERIAN, 2000 SPRING RD STE 200, OAK BROOK, 60523, DU PAGE Agent 2013-06-05

President

Name and Address Role
PETER BERNHARDT M.D. 800 W BIESTERFIELD RD ELK GROVE VILLAGE President

Shares

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

Related by officers

MATTHEW YETERIAN, 2000 SPRING RD STE 200, OAK BROOK, 60523, DU PAGE

PATHOLOGY ASSOCIATES OF CHICAGO, LTD.

Related by address

No related companies by address

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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