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NADEEM ANSARI, M.D., S.C.

Company Details

Entity Name: NADEEM ANSARI, M.D., S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 30 Nov 1992
Date of Dissolution: 10 Apr 2015
Company Number: CORP_57078057
File Number: 57078057
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 10 Apr 2015
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST 2014 363853769 2015-07-16 NADEEM ANSARI M.D. S.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8159291191
Plan sponsor’s address 400 RIVERSIDE DRIVE, SUITE 1600, BOURBONNAIS, IL, 60914

Signature of

Role Plan administrator
Date 2015-07-16
Name of individual signing NADEEM ANSARI
Valid signature Filed with authorized/valid electronic signature
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST 2013 363853769 2014-07-31 NADEEM ANSARI M.D. S.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8159291191
Plan sponsor’s address 400 RIVERSIDE DRIVE, SUITE 1600, BOURBONNAIS, IL, 60914

Signature of

Role Plan administrator
Date 2014-07-31
Name of individual signing NADEEM ANSARI
Valid signature Filed with authorized/valid electronic signature
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST 2012 363853769 2013-10-04 NADEEM ANSARI M.D. S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8159291191
Plan sponsor’s address 400 RIVERSIDE DRIVE, SUITE 1600, BOURBONNAIS, IL, 60914

Signature of

Role Plan administrator
Date 2013-10-04
Name of individual signing NADEEM ANSARI
Valid signature Filed with authorized/valid electronic signature
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST 2011 363853769 2012-10-11 NADEEM ANSARI M.D. S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8159374404
Plan sponsor’s address 401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901

Plan administrator’s name and address

Administrator’s EIN 363853769
Plan administrator’s name NADEEM ANSARI M.D. S.C.
Plan administrator’s address 401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901
Administrator’s telephone number 8159374404

Signature of

Role Plan administrator
Date 2012-10-11
Name of individual signing NADEEM ANSARI
Valid signature Filed with authorized/valid electronic signature
NADEEM ANSARI M.D. S.C. EMPLOYEES' PROFIT SHARING AND SAVINGS PLAN & TRUST 2010 363853769 2011-10-14 NADEEM ANSARI M.D. S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8159374404
Plan sponsor’s address 401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901

Plan administrator’s name and address

Administrator’s EIN 363853769
Plan administrator’s name NADEEM ANSARI M.D. S.C.
Plan administrator’s address 401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901
Administrator’s telephone number 8159374404

Signature of

Role Plan administrator
Date 2011-10-14
Name of individual signing NADEEM ANSARI
Valid signature Filed with authorized/valid electronic signature
NADEEM ANSARI M.D. S.C. EMPLOYEES PROFIT SHARING AND SAVINGS PLAN & TRUST 2009 363853769 2010-10-15 NADEEM ANSARI M.D. S.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8159374404
Plan sponsor’s address 401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901

Plan administrator’s name and address

Administrator’s EIN 363853769
Plan administrator’s name NADEEM ANSARI M.D. S.C.
Plan administrator’s address 401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901
Administrator’s telephone number 8159374404
NADEEM ANSARI M.D. S.C. EMPLOYEES PROFIT SHARING AND SAVINGS PLAN & TRUST 2009 363853769 2010-10-15 NADEEM ANSARI M.D. S.C. 7
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8159374404
Plan sponsor’s address 401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901

Plan administrator’s name and address

Administrator’s EIN 363853769
Plan administrator’s name NADEEM ANSARI M.D. S.C.
Plan administrator’s address 401 NORTH WALL STREET, SUITE 102, KANKAKEE, IL, 60901
Administrator’s telephone number 8159374404

Signature of

Role Plan administrator
Date 2010-10-15
Name of individual signing PAMELA MAHLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
NADEEM ANSARI, 400 RIVERSIDE DR 1600, BOURBONNAIS, 60914, KANKAKEE Agent 2012-10-22

President

Name and Address Role
NADEEM ANSARI, 292 BARRINGTON LANE BOURBONNAIS 60914 President

Shares

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

Sources: Illinois Office of the Secretary of State