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  5. ELM STREET PEDIATRICS, S.C.

ELM STREET PEDIATRICS, S.C.

Company Details

Entity Name: ELM STREET PEDIATRICS, S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 30 Oct 1998
Date of Dissolution: 14 Mar 2014
Company Number: CORP_60195927
File Number: 60195927
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 14 Mar 2014
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ELM STREET PEDIATRICS, S.C. RETIREMENT PLAN 2013 364266539 2014-10-06 ELM STREET PEDIATRICS, S.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8475014040
Plan sponsor’s address 572 LINCOLN AVENUE, SUITE 3, WINNETKA, IL, 60093

Signature of
Role Plan administrator
Date 2014-10-03
Name of individual signing SUSAN NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-03
Name of individual signing SUSAN NELSON
Valid signature Filed with authorized/valid electronic signature
ELM STREET PEDIATRICS, S.C. RETIREMENT PLAN 2012 364266539 2013-07-03 ELM STREET PEDIATRICS, S.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8475014040
Plan sponsor’s address 572 LINCOLN AVENUE, SUITE 3, WINNETKA, IL, 60093

Signature of
Role Plan administrator
Date 2013-07-03
Name of individual signing SUSAN NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-03
Name of individual signing SUSAN NELSON
Valid signature Filed with authorized/valid electronic signature
ELM STREET PEDIATRICS, S.C. RETIREMENT PLAN 2011 364266539 2012-07-19 ELM STREET PEDIATRICS, S.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8475014040
Plan sponsor’s address 572 LINCOLN AVE. SUITE 3, WINNETKA, IL, 60093

Plan administrator’s name and address
Administrator’s EIN 364266539
Plan administrator’s name ELM STREET PEDIATRICS, S.C.
Plan administrator’s address 572 LINCOLN AVE. SUITE 3, WINNETKA, IL, 60093
Administrator’s telephone number 8475014040

Signature of
Role Plan administrator
Date 2012-07-19
Name of individual signing SUSAN NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-19
Name of individual signing SUSAN NELSON
Valid signature Filed with authorized/valid electronic signature
ELM STREET PEDIATRICS, S.C. RETIREMENT PLAN 2010 364266539 2011-10-13 ELM STREET PEDIATRICS, S.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8475014040
Plan sponsor’s address 716 ELM STREET, WINNETKA, IL, 60093

Plan administrator’s name and address
Administrator’s EIN 364266539
Plan administrator’s name ELM STREET PEDIATRICS, S.C.
Plan administrator’s address 716 ELM STREET, WINNETKA, IL, 60093
Administrator’s telephone number 8475014040

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing SUSAN NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-13
Name of individual signing SUSAN NELSON
Valid signature Filed with authorized/valid electronic signature
ELM STREET PEDIATRICS, S.C. RETIREMENT PLAN 2009 364266539 2010-10-04 ELM STREET PEDIATRICS, S.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8475014040
Plan sponsor’s address 716 ELM STREET, WINNETKA, IL, 60093

Plan administrator’s name and address
Administrator’s EIN 364266539
Plan administrator’s name ELM STREET PEDIATRICS, S.C.
Plan administrator’s address 716 ELM STREET, WINNETKA, IL, 60093
Administrator’s telephone number 8475014040

Signature of
Role Plan administrator
Date 2010-10-04
Name of individual signing SUSAN J. NELSON, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-04
Name of individual signing SUSAN J. NELSON, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SEAN D AUTON, 500 W MADISON ST STE 3700, CHICAGO, 60661, COOK-NOT IN CITY OF CHICAGO Agent 2011-03-23

President

Name and Address Role
SUSAN NELSON, 572 LINCOLN AVE., SUITE #3, WINNETKA 60093 President

Historical Names

Name Change Date
SUSAN J. NELSON, M.D., S.C. 1999-06-10

Shares

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

Related by officers

SEAN D AUTON, 500 W MADISON ST STE 3700, CHICAGO, 60661, COOK-NOT IN CITY OF CHICAGO

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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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