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  5. SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C.

SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C.

Company Details

Entity Name: SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 09 Jul 1999
Company Number: CORP_60575282
File Number: 60575282
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
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2019 371387418 2020-10-13 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2018 371387418 2019-10-07 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2017 371387418 2018-08-20 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2016 371387418 2017-06-02 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2015 371387418 2016-09-30 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2014 371387418 2015-07-28 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2013 371387418 2014-08-26 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2012 371387418 2013-07-12 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837

Signature of
Role Plan administrator
Date 2013-07-08
Name of individual signing PATRICK MOLT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2011 371387418 2012-07-12 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s mailing address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837

Plan administrator’s name and address
Administrator’s EIN 371387418
Plan administrator’s name SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C.
Plan administrator’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
Administrator’s telephone number 6188423813

Number of participants as of the end of the plan year
Active participants 2
Number of participants with account balances as of the end of the plan year 2

Signature of
Role Plan administrator
Date 2012-07-09
Name of individual signing PATRICK MOLT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. PROFIT SHARING PLAN 2011 371387418 2012-07-09 SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C. 2
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6188423813
Plan sponsor’s mailing address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
Plan sponsor’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837

Plan administrator’s name and address
Administrator’s EIN 371387418
Plan administrator’s name SOUTHERN ILLINOIS SURGICAL CARE ASSOCIATES, P.C.
Plan administrator’s address 207 NORTHWEST TENTH STREET, FAIRFIELD, IL, 62837
Administrator’s telephone number 6188423813

Number of participants as of the end of the plan year
Active participants 2
Number of participants with account balances as of the end of the plan year 2

Signature of
Role Plan administrator
Date 2012-07-09
Name of individual signing PATRICK MOLT
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name and Address Role Appointment Date
PATRICK L MOLT, 207 NORTHWEST TENTH ST, FAIRFIELD, 62837, WAYNE Agent 1999-07-09

President

Name and Address Role
PATRICK L MOLT, 2095 C.R. 1370 N FAIRFIELD IL 62837 President

Secretary

Name and Address Role
PATRICK L MOLT Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100 10000 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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