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BLAKE HORIO, M.D., LTD.

Company Details

Entity Name: BLAKE HORIO, M.D., LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 26 Jun 1997
Company Number: CORP_59480235
File Number: 59480235
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
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2017 364166076 2018-12-03 BLAKE HORIO, M.D., LTD. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6307342000
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Signature of

Role Plan administrator
Date 2018-12-03
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2017 364166076 2018-05-22 BLAKE HORIO, M.D., LTD. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6307342000
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Signature of

Role Plan administrator
Date 2018-05-22
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2016 364166076 2017-05-12 BLAKE HORIO, M.D., LTD. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6307342000
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Signature of

Role Plan administrator
Date 2017-05-12
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2015 364166076 2016-07-28 BLAKE HORIO, M.D., LTD. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6307342000
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Signature of

Role Plan administrator
Date 2016-07-28
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-26
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2014 364166076 2015-09-14 BLAKE HORIO, M.D., LTD. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6307342000
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Signature of

Role Plan administrator
Date 2015-09-11
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-11
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2013 364166076 2014-09-13 BLAKE HORIO, M.D., LTD. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6307342000
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Signature of

Role Plan administrator
Date 2014-09-13
Name of individual signing BLAKE HORIO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-09-13
Name of individual signing BLAKE HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2012 364166076 2013-09-20 BLAKE HORIO, M.D., LTD. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6307342000
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Signature of

Role Plan administrator
Date 2013-09-20
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-20
Name of individual signing BETH HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2011 364166076 2012-10-04 BLAKE HORIO, M.D., LTD. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6307342000
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Plan administrator’s name and address

Administrator’s EIN 364166076
Plan administrator’s name BLAKE HORIO, M.D., LTD.
Plan administrator’s address 710 N. YORK ROAD, HINSDALE, IL, 60521
Administrator’s telephone number 6307342000

Signature of

Role Plan administrator
Date 2012-10-04
Name of individual signing BLAKE HORIO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-04
Name of individual signing BLAKE HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2010 364166076 2011-09-06 BLAKE HORIO, M.D., LTD. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6303255583
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Plan administrator’s name and address

Administrator’s EIN 364166076
Plan administrator’s name BLAKE HORIO, M.D., LTD.
Plan administrator’s address 710 N. YORK ROAD, HINSDALE, IL, 60521
Administrator’s telephone number 6303255583

Signature of

Role Plan administrator
Date 2011-09-06
Name of individual signing BLAKE HORIO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-06
Name of individual signing BLAKE HORIO
Valid signature Filed with authorized/valid electronic signature
BLAKE HORIO, M.D., LTD. 401(K) PROFIT SHARING PLAN 2009 364166076 2010-05-24 BLAKE HORIO, M.D., LTD. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6303255583
Plan sponsor’s address 710 N. YORK ROAD, HINSDALE, IL, 60521

Plan administrator’s name and address

Administrator’s EIN 364166076
Plan administrator’s name BLAKE HORIO, M.D., LTD.
Plan administrator’s address 710 N. YORK ROAD, HINSDALE, IL, 60521
Administrator’s telephone number 6303255583

Signature of

Role Plan administrator
Date 2010-05-24
Name of individual signing BLAKE HORIO
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DANIEL MCCORMICK, 5205 WASHINGTON STREET, DOWNERS GROVE, 60515, DU PAGE Agent 2023-05-18

President

Name and Address Role
BLAKE H HORIO 96 MIRAGE VIEW DR HENDERSON NV 89011 President

Secretary

Name and Address Role
BLAKE H HORIO Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
RETINA GROUP CHICAGO Assume Name 2011-06-02 No data No data No data
MIDWEST RETINA CENTER No data 2006-12-13 2011-06-20 Voluntary Cancellation No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100000 1000000 No data

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State