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  5. JAMES J. GOMEZ, M.D., S.C.

JAMES J. GOMEZ, M.D., S.C.

Company Details

Entity Name: JAMES J. GOMEZ, M.D., S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 02 Jun 2000
Company Number: CORP_61070109
File Number: 61070109
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
JAMES J. GOMEZ, M.D., S.C. EMPLOYEE BENEFIT PLAN & TRUST 2012 364372627 2013-10-10 JAMES J. GOMEZ, M.D., S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7084530866
Plan sponsor’s address 675 W. NORTH AVENUE, MELROSE PARK, IL, 60160

Plan administrator’s name and address
Administrator’s EIN 364372627
Plan administrator’s name JAMES J. GOMEZ, M.D., S.C.
Plan administrator’s address 675 W. NORTH AVENUE, MELROSE PARK, IL, 60160
Administrator’s telephone number 7084530866

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing JAMES GOMEZ
Valid signature Filed with authorized/valid electronic signature
JAMES J. GOMEZ, M.D., S.C. EMPLOYEE BENEFIT PLAN & TRUST 2011 364372627 2012-07-31 JAMES J. GOMEZ, M.D., S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7084530866
Plan sponsor’s address 675 W. NORTH AVENUE, MELROSE PARK, IL, 60160

Plan administrator’s name and address
Administrator’s EIN 364372627
Plan administrator’s name JAMES J. GOMEZ, M.D., S.C.
Plan administrator’s address 675 W. NORTH AVENUE, MELROSE PARK, IL, 60160
Administrator’s telephone number 7084530866

Signature of
Role Plan administrator
Date 2012-07-30
Name of individual signing JAMES GOMEZ
Valid signature Filed with authorized/valid electronic signature
JAMES J. GOMEZ, M.D., S.C. EMPLOYEE BENEFIT PLAN & TRUST 2010 364372627 2011-07-31 JAMES J. GOMEZ, M.D., S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7084530866
Plan sponsor’s address 675 W. NORTH AVENUE, MELROSE PARK, IL, 60160

Plan administrator’s name and address
Administrator’s EIN 364372627
Plan administrator’s name JAMES J. GOMEZ, M.D., S.C.
Plan administrator’s address 675 W. NORTH AVENUE, MELROSE PARK, IL, 60160
Administrator’s telephone number 7084530866

Signature of
Role Plan administrator
Date 2011-07-30
Name of individual signing JAMES GOMEZ
Valid signature Filed with authorized/valid electronic signature
JAMES J. GOMEZ, M.D., S.C. EMPLOYEE BENEFIT PLAN & TRUST 2009 364372627 2010-07-28 JAMES J. GOMEZ, M.D., S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7084530866
Plan sponsor’s address 675 W. NORTH AVENUE, MELROSE PARK, IL, 60160

Plan administrator’s name and address
Administrator’s EIN 364372627
Plan administrator’s name JAMES J. GOMEZ, M.D., S.C.
Plan administrator’s address 675 W. NORTH AVENUE, MELROSE PARK, IL, 60160
Administrator’s telephone number 7084530866

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing JAMES GOMEZ
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MICHAEL C ROBERTS, 4042 N ELSTON, CHICAGO, 60618, COOK-NOT IN CITY OF CHICAGO Agent 2016-06-17

President

Name and Address Role
JAMES J. GOMEZ M.D. 10215 W. ROOSEVELT ROAD, WESTCHESTER, IL President

Shares

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

Related by officers

MICHAEL C ROBERTS, 4042 N ELSTON, CHICAGO, 60618, COOK-NOT IN CITY OF CHICAGO

COONEY FUNERAL HOME, LTD. LAW OFFICE OF MICHAEL C. ROBERTS, P.C. SPECIALTY CLOSURES AND EQUIPMENT, INC. SRD SERVICES CORP.

Related by address

No related companies by address

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State

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