| Entity Name: | SUSAN C. BALVERDE, M.D.,S.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 12 Dec 1994 |
| Date of Dissolution: | 12 May 2017 |
| Company Number: | CORP_58105651 |
| File Number: | 58105651 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Date Status Change: | 12 May 2017 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUSAN L. BALVERDE, M.D., S.C. DEFINED BENEFIT PLAN | 2010 | 363993841 | 2011-10-03 | SUSAN C. BALVERDE, M.D., S.C. | 6 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 363993841 |
| Plan administrator’s name | SUSAN C. BALVERDE, M.D., S.C. |
| Plan administrator’s address | 675 W. NORTH AVE, MELROSE PARK, IL, 60160 |
| Administrator’s telephone number | 7085449690 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-03 |
| Name of individual signing | STEPHEN OMALLEY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2003-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7085449690 |
| Plan sponsor’s address | 675 W. NORTH AVE, MELROSE PARK, IL, 60160 |
Plan administrator’s name and address
| Administrator’s EIN | 363993841 |
| Plan administrator’s name | SUSAN C. BALVERDE, M.D., S.C. |
| Plan administrator’s address | 675 W. NORTH AVE, MELROSE PARK, IL, 60160 |
| Administrator’s telephone number | 7085449690 |
Signature of
| Role | Plan administrator |
| Date | 2010-08-30 |
| Name of individual signing | JAMES CONSOLATI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| ADOR BALVERDE, 22361 NORTH BROOKSIDE WAY, LAKE BARRINGTON, 60010, COOK-NOT IN CITY OF CHICAGO | Agent | 2007-12-11 |
| Name and Address | Role |
|---|---|
| PRESIDENT- SUSAN C BALVERDE 5524 N PIONEER AVE. CHICAGO, IL | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMM | No data | Voting Rights | 250 | 50000 | No data |
Date of last update: 27 Jan 2025
