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  5. ATI VANDENBERG AMBULANCE, INC.

ATI VANDENBERG AMBULANCE, INC.

Company Details

Entity Name: ATI VANDENBERG AMBULANCE, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 02 Dec 1999
Company Number: CORP_60784221
File Number: 60784221
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

Agent

Name and Address Role Appointment Date
CARL VANDENBERG, 8410 W 183RD PLACE, TINLEY PARK, 60487, WILL Agent 2008-05-12

President

Name and Address Role
CHRISTOPHER J VANDENBERG 8410W183RD PL TINLEY PARK, 60487 President

Secretary

Name and Address Role
CHRISTOPHER J VANDENBERG 8410W183RD PL TINLEY PARK 60487 Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
MEDCARE AMBULANCE No data 2004-10-18 2016-05-02 Involuntary Cancellation No data

Historical Names

Name Change Date
BLACKHAWK MEDICAL TRANSPORTATION, INC. 2022-02-21
BLACKHAWK MEDICAL TRANSPORATION, INC. 2000-09-15

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 200000 No data

USAspending Awards. Contracts

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DELIVERY ORDER AWARD 36C25223N0048 2022-10-01 2023-09-30 2024-09-30
Unique Award Key CONT_AWD_36C25223N0048_3600_36C25220D0008_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 0.00
Current Award Amount 589820.36
Potential Award Amount 589820.36

Description
Title FY23 TO HINES AMBULANCE SERVICES
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Recipient Address UNITED STATES, 8400 183RD PL STE 1, TINLEY PARK, WILL, ILLINOIS, 604879300
DELIVERY ORDER AWARD 36C25222N0003 2021-10-01 2022-09-30 2024-09-30
Unique Award Key CONT_AWD_36C25222N0003_3600_36C25220D0008_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 1614140.50
Current Award Amount 1614140.50
Potential Award Amount 1614140.50

Description
Title AMBULANCE SERVICES FOR FY22
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Recipient Address UNITED STATES, 8400 183RD PL STE 1, TINLEY PARK, WILL, ILLINOIS, 604879300
DELIVERY ORDER AWARD 36C25220N0543 2020-03-01 2021-09-30 2024-09-30
Unique Award Key CONT_AWD_36C25220N0543_3600_36C25220D0008_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 5200.00
Current Award Amount 5200.00
Potential Award Amount 5200.00

Description
Title TRANSPORTS OF DECEASED FROM 3/1/2020 - 6/30/2020
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Recipient Address UNITED STATES, 8400 183RD PL STE 1, TINLEY PARK, WILL, ILLINOIS, 604879300
DCA AWARD VA69D12C0252 2012-09-01 2012-11-01 2012-11-01
Unique Award Key CONT_AWD_VA69D12C0252_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title IGF::OT::IGF OTHER FUNCTIONS: INTERIM AMBULANCE SERVICES
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Legacy DUNS 064871176
Recipient Address 8400 183RD PL STE 1, TINLEY PARK, 604779213, UNITED STATES
DO AWARD VA69D12J0621 2012-09-01 2012-09-30 2012-09-30
Unique Award Key CONT_AWD_VA69D12J0621_3600_V69DP5262_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title OTHER FUNCTION: AMBULANCE SERVICES
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Legacy DUNS 064871176
Recipient Address 8040 185TH ST, TINLEY PARK, 604779213, UNITED STATES
DCA AWARD VA69D12C0228 2012-07-01 2012-11-01 2012-11-01
Unique Award Key CONT_AWD_VA69D12C0228_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title IGF::OT::IGF OTHER FUNCTIONS: HINES INTERIM AMBULANCE CONTRACT ADMIN MOD
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Legacy DUNS 064871176
Recipient Address 8400 183RD PL STE 1, TINLEY PARK, 604779213, UNITED STATES
No data IDV VA69DP0698 2012-03-01 No data No data
Unique Award Key CONT_IDV_VA69DP0698_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title OPTION TO EXTEND 4 MONTHS.
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Legacy DUNS 064871176
Recipient Address 8400 183RD PL STE 1, TINLEY PARK, 604779213, UNITED STATES
DO AWARD VA69D12J1913 2012-03-01 2012-06-30 2012-06-30
Unique Award Key CONT_AWD_VA69D12J1913_3600_VA69DP0698_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title IGF::OT::IGF OTHER FUNCTION - 4 MONTH EXTENSION
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Legacy DUNS 064871176
Recipient Address 8400 183RD PL STE 1, TINLEY PARK, 604779213, UNITED STATES
DO AWARD VA69D12J0536 2011-09-01 2012-02-29 2012-02-29
Unique Award Key CONT_AWD_VA69D12J0536_3600_VA69DP0698_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title VA69D-P-0698, ALS/BLS AMBULANCE SERVICE (15 MIN. RESPONSE)FOR HINES VA.
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Legacy DUNS 064871176
Recipient Address 8400 183RD PL STE 1, TINLEY PARK, 604779213, UNITED STATES
DO AWARD VA69D537C10149 2010-10-01 2011-01-31 2011-01-31
Unique Award Key CONT_AWD_VA69D537C10149_3600_V69DP5262_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient BLACKHAWK MEDICAL TRANSPORTATION INC
UEI KGJMDN1P38G9
Legacy DUNS 064871176
Recipient Address 8040 185TH ST, TINLEY PARK, 604779213, UNITED STATES

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3507538500 2021-02-24 0507 PPS 8410 183rd Pl, Tinley Park, IL, 60487-9268
Loan Status Date 2021-07-17
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 272902
Loan Approval Amount (current) 272902
Undisbursed Amount 0
Franchise Name -
Lender Location ID 20400
Servicing Lender Name CNB Bank and Trust, National Association
Servicing Lender Address 450 West Side Sq, CARLINVILLE, IL, 62626-1700
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Tinley Park, WILL, IL, 60487-9268
Project Congressional District IL-01
Number of Employees 274
NAICS code 621910
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 20400
Originating Lender Name CNB Bank and Trust, National Association
Originating Lender Address CARLINVILLE, IL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 273728.29
Forgiveness Paid Date 2021-06-15
7203477008 2020-04-07 0507 PPP 8400 183RD PL, TINLEY PARK, IL, 60487-4500
Loan Status Date 2021-05-26
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 256500
Loan Approval Amount (current) 256521
Undisbursed Amount 0
Franchise Name -
Lender Location ID 438799
Servicing Lender Name Old Plank Trail Community Bank, National Association
Servicing Lender Address 20012 Wolf Rd, MOKENA, IL, 60448-9953
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address TINLEY PARK, WILL, IL, 60487-4500
Project Congressional District IL-01
Number of Employees 45
NAICS code 621910
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 438799
Originating Lender Name Old Plank Trail Community Bank, National Association
Originating Lender Address MOKENA, IL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 257946.12
Forgiveness Paid Date 2020-11-03

Related by officers

CARL VANDENBERG, 8410 W 183RD PLACE, TINLEY PARK, 60487, WILL

QUALITY WHEELCHAIR TRANSPORTATION, INC.

Related by address

No related companies by address

Date of last update: 13 Mar 2025

Sources: Illinois Office of the Secretary of State

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