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  5. FAMILY DOCTORS OF DUPAGE S.C.

FAMILY DOCTORS OF DUPAGE S.C.

Company Details

Entity Name: FAMILY DOCTORS OF DUPAGE S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 19 Jul 1991
Company Number: CORP_56468366
File Number: 56468366
Type of Business: Incorporated under the Medical Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY DOCTORS OF DUPAGE, S.C. RETIREMENT SAVINGS PLAN 2016 363776738 2018-12-18 FAMILY DOCTORS OF DUPAGE, S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6308939661
Plan sponsor’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
FAMILY DOCTORS OF DUPAGE, S.C. RETIREMENT SAVINGS PLAN 2015 363776738 2016-10-17 FAMILY DOCTORS OF DUPAGE, S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6308939661
Plan sponsor’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
FAMILY DOCTORS OF DUPAGE, S.C. RETIREMENT SAVINGS PLAN 2014 363776738 2015-10-07 FAMILY DOCTORS OF DUPAGE, S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6308939661
Plan sponsor’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
FAMILY DOCTORS OF DUPAGE, S.C. RETIREMENT SAVINGS PLAN 2013 363776738 2014-10-14 FAMILY DOCTORS OF DUPAGE, S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6308939661
Plan sponsor’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
FAMILY DOCTORS OF DUPAGE, S.C. RETIREMENT SAVINGS PLAN 2012 363776738 2013-10-15 FAMILY DOCTORS OF DUPAGE, S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6308939661
Plan sponsor’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing WILLIAM L. EPPERLY, M.D.
Valid signature Filed with authorized/valid electronic signature
FAMILY DOCTORS OF DUPAGE, S.C. RETIREMENT SAVINGS PLAN 2011 363776738 2012-10-09 FAMILY DOCTORS OF DUPAGE, S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6308939661
Plan sponsor’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108

Plan administrator’s name and address
Administrator’s EIN 363776738
Plan administrator’s name FAMILY DOCTORS OF DUPAGE, S.C.
Plan administrator’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
Administrator’s telephone number 6308939661

Signature of
Role Plan administrator
Date 2012-10-08
Name of individual signing WILLIAM L. EPPERLY, M.D.
Valid signature Filed with authorized/valid electronic signature
FAMILY DOCTORS OF DUPAGE, S.C. RETIREMENT SAVINGS PLAN 2010 363776738 2011-10-14 FAMILY DOCTORS OF DUPAGE, S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6308939661
Plan sponsor’s mailing address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
Plan sponsor’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108

Plan administrator’s name and address
Administrator’s EIN 363776738
Plan administrator’s name FAMILY DOCTORS OF DUPAGE, S.C.
Plan administrator’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
Administrator’s telephone number 6308939661

Number of participants as of the end of the plan year
Active participants 3
Number of participants with account balances as of the end of the plan year 3

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing WILLIAM L. EPPERLY, M.D.
Valid signature Filed with authorized/valid electronic signature
FAMILY DOCTORS OF DUPAGE, S.C. RETIREMENT SAVINGS PLAN 2009 363776738 2010-10-12 FAMILY DOCTORS OF DUPAGE, S.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6308939661
Plan sponsor’s mailing address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
Plan sponsor’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108

Plan administrator’s name and address
Administrator’s EIN 363776738
Plan administrator’s name FAMILY DOCTORS OF DUPAGE, S.C.
Plan administrator’s address 245 SOUTH GARY AVENUE, SUITE 105, BLOOMINGDALE, IL, 60108
Administrator’s telephone number 6308939661

Number of participants as of the end of the plan year
Active participants 3
Number of participants with account balances as of the end of the plan year 3
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of
Role Plan administrator
Date 2010-10-11
Name of individual signing WILLIAM L. EPPERLY, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ADAM PUTTKAMMER, 882 EDGEWOOD DRIVE, SUGAR GROVE, 60554, KANE Agent 2022-07-08

President

Name and Address Role
WILLIAM EPPERLY, 1132 FALCON RIDGE DRIVE, ELGIN, IL 60124 President

Secretary

Name and Address Role
WILLIAM EPPERLY Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
FORUM HEALTH BLOOMINGDALE Assume Name 2023-11-02 No data No data No data
ADVANCED INTEGRATIVE HEALTHCARE Assume Name 2022-09-14 No data No data No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 1000 100000 No data

Related by officers

No related officers

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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