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  5. SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.

SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.

Company Details

Entity Name: SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 08 Feb 2001
Date of Dissolution: 12 Jul 2013
Company Number: CORP_61485341
File Number: 61485341
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 12 Jul 2013
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 401(K) PROFIT SHARING PLAN 2012 371405826 2013-03-20 SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-04-01
Business code 621111
Sponsor’s telephone number 6189989600
Plan sponsor’s address 3314 PATRIOT COURT, HERRIN, IL, 62948

Signature of
Role Plan administrator
Date 2013-03-20
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-20
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 401(K) PROFIT SHARING PLAN 2011 371405826 2013-01-04 SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 6
Three-digit plan number (PN) 002
Effective date of plan 2010-04-01
Business code 621111
Sponsor’s telephone number 6189989600
Plan sponsor’s address 3314 PATRIOT COURT, HERRIN, IL, 62948

Plan administrator’s name and address
Administrator’s EIN 371405826
Plan administrator’s name SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.
Plan administrator’s address 3314 PATRIOT COURT, HERRIN, IL, 62948
Administrator’s telephone number 6189989600

Signature of
Role Plan administrator
Date 2013-01-04
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-01-04
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. CASH BALANCE PENSION PLAN 2011 371405826 2012-09-13 SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-04-01
Business code 621111
Sponsor’s telephone number 6187512071
Plan sponsor’s address 3314 PATRIOT COURT, HERRIN, IL, 62948

Plan administrator’s name and address
Administrator’s EIN 371405826
Plan administrator’s name SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.
Plan administrator’s address 3314 PATRIOT COURT, HERRIN, IL, 62948
Administrator’s telephone number 6187512071

Signature of
Role Plan administrator
Date 2012-09-13
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-13
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. CASH BALANCE PENSION PLAN 2011 371405826 2012-06-14 SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-04-01
Business code 621111
Sponsor’s telephone number 6189989600
Plan sponsor’s address 3314 PATRIOT COURT, HERRIN, IL, 62948

Plan administrator’s name and address
Administrator’s EIN 371405826
Plan administrator’s name SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.
Plan administrator’s address 3314 PATRIOT COURT, HERRIN, IL, 62948
Administrator’s telephone number 6189989600

Signature of
Role Plan administrator
Date 2012-06-14
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-14
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 401(K) PROFIT SHARING PLAN 2011 371405826 2012-06-12 SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-04-01
Business code 621111
Sponsor’s telephone number 6189989600
Plan sponsor’s address 3314 PATRIOT COURT, HERRIN, IL, 62948

Plan administrator’s name and address
Administrator’s EIN 371405826
Plan administrator’s name SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.
Plan administrator’s address 3314 PATRIOT COURT, HERRIN, IL, 62948
Administrator’s telephone number 6189989600

Signature of
Role Plan administrator
Date 2012-06-12
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-12
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 401(K) PROFIT SHARING PLAN 2010 371405826 2011-07-20 SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-04-01
Business code 621111
Sponsor’s telephone number 6189989600
Plan sponsor’s address 3314 PATRIOT COURT, HERRIN, IL, 62948

Plan administrator’s name and address
Administrator’s EIN 371405826
Plan administrator’s name SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.
Plan administrator’s address 3314 PATRIOT COURT, HERRIN, IL, 62948
Administrator’s telephone number 6189989600

Signature of
Role Plan administrator
Date 2011-07-20
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-20
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. CASH BALANCE PENSION PLAN 2010 371405826 2011-07-20 SOUTHERN ILLINOIS PLASTIC SURGERY, P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-04-01
Business code 621111
Sponsor’s telephone number 6189989600
Plan sponsor’s address 3314 PATRIOT COURT, HERRIN, IL, 62948

Plan administrator’s name and address
Administrator’s EIN 371405826
Plan administrator’s name SOUTHERN ILLINOIS PLASTIC SURGERY, P.C.
Plan administrator’s address 3314 PATRIOT COURT, HERRIN, IL, 62948
Administrator’s telephone number 6189989600

Signature of
Role Plan administrator
Date 2011-07-20
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-20
Name of individual signing SUZANNE GAUTO
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
CARLOS E TANNER, 509 1/2 E DEYOUNG ST, MARION, 62959, WILLIAMSON Agent 2012-01-17

President

Name and Address Role
NELSON F GAUTO, 3307 LOGAN DR HERRIN 62948 President

Historical Names

Name Change Date
NELSON F. GAUTO, M.D., P.C. 2001-05-21

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 1000000 No data

Related by officers

CARLOS E TANNER, 509 1/2 E DEYOUNG ST, MARION, 62959, WILLIAMSON

EGYPTIAN EXTERMINATING INC.

Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State

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