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  5. FPA OF ILLINOIS CHAPTER, INCORPORATED

FPA OF ILLINOIS CHAPTER, INCORPORATED

Company Details

Entity Name: FPA OF ILLINOIS CHAPTER, INCORPORATED
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 28 Dec 2000
Company Number: CORP_61408495
File Number: 61408495
Type of Business: Educational, research or scientific
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WILLOW RIDGE DENTAL ASSOCIATES DEFINED BENEFIT PLAN 2010 364043134 2011-08-31 WILLOW RIDGE DENTAL ASSOCIATES 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6304202800
Plan sponsor’s address 720 SOUTH BROM DR, SUITE 105, NAPERVILLE, IL, 60540

Plan administrator’s name and address
Administrator’s EIN 364043134
Plan administrator’s name WILLOW RIDGE DENTAL ASSOCIATES
Plan administrator’s address 720 SOUTH BROM DR, SUITE 105, NAPERVILLE, IL, 60540
Administrator’s telephone number 6304202800

Signature of
Role Plan administrator
Date 2011-08-31
Name of individual signing ROBERT PETERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-08-31
Name of individual signing ROBERT PETERSON
Valid signature Filed with authorized/valid electronic signature
WILLOW RIDGE DENTAL ASSOCIATES PROFIT SHARING PLAN 2010 364043134 2010-09-01 WILLOW RIDGE DENTAL ASSOCIATES 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6304202800
Plan sponsor’s address 720 SOUTH BROM DRIVE, SUITE 105, NAPERVILLE, IL, 60540

Plan administrator’s name and address
Administrator’s EIN 364043134
Plan administrator’s name WILLOW RIDGE DENTAL ASSOCIATES
Plan administrator’s address 720 SOUTH BROM DRIVE, SUITE 105, NAPERVILLE, IL, 60540
Administrator’s telephone number 6304202800

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing ROBERT PETERSON
Valid signature Filed with authorized/valid electronic signature
WILLOW RIDGE DENTAL ASSOCIATES DEFINED BENEFIT PLAN 2009 364043134 2011-08-31 WILLOW RIDGE DENTAL ASSOCIATES 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6304202800
Plan sponsor’s address 720 SOUTH BROM DR, SUITE 105, NAPERVILLE, IL, 60540

Plan administrator’s name and address
Administrator’s EIN 364043134
Plan administrator’s name WILLOW RIDGE DENTAL ASSOCIATES
Plan administrator’s address 720 SOUTH BROM DR, SUITE 105, NAPERVILLE, IL, 60540
Administrator’s telephone number 6304202800

Signature of
Role Plan administrator
Date 2011-08-31
Name of individual signing ROBERT PETERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-08-31
Name of individual signing ROBERT PETERSON
Valid signature Filed with authorized/valid electronic signature
WILLOW RIDGE DENTAL ASSOCIATES DEFINED BENEFIT PLAN 2009 364043134 2010-09-29 WILLOW RIDGE DENTAL ASSOCIATES 3
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6304202800
Plan sponsor’s address 720 SOUTH BROM DR, SUITE 105, NAPERVILLE, IL, 60540

Plan administrator’s name and address
Administrator’s EIN 364043134
Plan administrator’s name WILLOW RIDGE DENTAL ASSOCIATES
Plan administrator’s address 720 SOUTH BROM DR, SUITE 105, NAPERVILLE, IL, 60540
Administrator’s telephone number 6304202800

Signature of
Role Plan administrator
Date 2010-09-29
Name of individual signing ROBERT PETERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-29
Name of individual signing ROBERT PETERSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
KRISTIN PRINE, 14545 KOSTNER AVE, MIDLOTHIAN, 60445, COOK-NOT IN CITY OF CHICAGO Agent 2019-01-04

Related by officers

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Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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