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  5. BOULEVARD PEDIATRICS S.C.

BOULEVARD PEDIATRICS S.C.

Company Details

Entity Name: BOULEVARD PEDIATRICS S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 16 Nov 2000
Date of Dissolution: 13 Apr 2018
Company Number: CORP_61342613
File Number: 61342613
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 13 Apr 2018
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BOULEVARD PEDIATRICS, S.C. P/S & 401K PLAN 2017 364404561 2019-07-23 BOULEVARD PEDIATRICS S C 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 7110 WEST 127TH ST, SUITE 230, PALOS HEIGHTS, IL, 60463

Signature of
Role Plan administrator
Date 2019-07-23
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-23
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
BOULEVARD PEDIATRICS, S.C. P/S & 401K PLAN 2016 364404561 2017-05-19 BOULEVARD PEDIATRICS S C 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-19
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
BOULEVARD PEDIATRICS, S.C. P/S & 401K PLAN 2015 364404561 2016-06-21 BOULEVARD PEDIATRICS S C 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461

Signature of
Role Plan administrator
Date 2016-06-21
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-21
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
BOULEVARD PEDIATRICS SC PS 401K PLAN 2014 364404561 2015-12-14 BOULEVARD PEDIATRICS S C 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461

Signature of
Role Plan administrator
Date 2015-12-14
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-12-14
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
BOULEVARD PEDIATRICS, S.C. P/S & 401K PLAN 2013 364404561 2014-06-30 BOULEVARD PEDIATRICS S C 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461

Signature of
Role Plan administrator
Date 2014-06-30
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-30
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
BOULEVARD PEDIATRICS, S.C. P/S & 401K PLAN 2012 364404561 2013-05-16 BOULEVARD PEDIATRICS S C 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461

Signature of
Role Plan administrator
Date 2013-05-16
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-16
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
BOULEVARD PEDIATRICS, S.C. P/S & 401K PLAN 2011 364404561 2012-09-07 BOULEVARD PEDIATRICS S C 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461

Plan administrator’s name and address
Administrator’s EIN 364404561
Plan administrator’s name BOULEVARD PEDIATRICS S C
Plan administrator’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461
Administrator’s telephone number 7087554401

Signature of
Role Plan administrator
Date 2012-09-05
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-07
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
BOULEVARD PEDIATRICS SC PS 401K PLAN 2010 364404561 2011-07-26 BOULEVARD PEDIATRICS S C 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461

Plan administrator’s name and address
Administrator’s EIN 364404561
Plan administrator’s name BOULEVARD PEDIATRICS S C
Plan administrator’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461
Administrator’s telephone number 7087554401

Signature of
Role Plan administrator
Date 2011-07-26
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-24
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
BOULEVARD PEDIATRICS SC PS 401K PLAN 2009 364404561 2010-08-12 BOULEVARD PEDIATRICS S C 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7087554401
Plan sponsor’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461

Plan administrator’s name and address
Administrator’s EIN 364404561
Plan administrator’s name BOULEVARD PEDIATRICS S C
Plan administrator’s address 20917 SPARTA LANE, OLYMPIA FIELDS, IL, 60461
Administrator’s telephone number 7087554401

Signature of
Role Plan administrator
Date 2010-08-10
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-12
Name of individual signing ANTONIO MARRA
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ANTONIO MARRA, 20917 SPARTA LN, OLYMPIA FIELDS, 60461, COOK-NOT IN CITY OF CHICAGO Agent 2000-11-16

President

Name and Address Role
ANTONIO MARRA, 20917 SPARTA LN., OLYMPIA FIELDS, IL, 60461 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 100000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Jan 2025

Sources: Illinois Office of the Secretary of State

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