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ELGIN FAMILY PHYSICIANS, S.C.

Company Details

Entity Name: ELGIN FAMILY PHYSICIANS, S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 03 Jul 2001
Company Number: CORP_61712151
File Number: 61712151
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
ELGIN FAMILY PHYSICIANS, S.C. PROFIT SHARING PLAN 2020 363780199 2022-05-05 ELGIN FAMILY PHYSICIANS, S.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8478883661
Plan sponsor’s address 87 N AIRLITE STREET, SUITE 130, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2022-05-04
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-04
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
ELGIN FAMILY PHYSICIANS, S.C. PROFIT SHARING PLAN 2020 363780199 2021-04-19 ELGIN FAMILY PHYSICIANS, S.C. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8478883661
Plan sponsor’s address 87 N AIRLITE STREET, SUITE 130, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2021-04-19
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-19
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
ELGIN FAMILY PHYSICIANS, S.C. PROFIT SHARING PLAN 2019 363780199 2020-08-05 ELGIN FAMILY PHYSICIANS, S.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8478883661
Plan sponsor’s address 87 N AIRLITE STREET, SUITE 130, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2020-08-05
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-05
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
ELGIN FAMILY PHYSICIANS, S.C. PROFIT SHARING PLAN 2018 363780199 2019-06-03 ELGIN FAMILY PHYSICIANS, S.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8478883661
Plan sponsor’s address 87 N AIRLITE STREET, SUITE 130, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2019-06-03
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-03
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
ELGIN FAMILY PHYSICIANS, S.C. PROFIT SHARING PLAN 2017 363780199 2018-10-11 ELGIN FAMILY PHYSICIANS, S.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8478883661
Plan sponsor’s address 87 N AIRLITE STREET, SUITE 130, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2018-10-11
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-11
Name of individual signing DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
ELGIN FAMILY PHYSICIANS, S.C. PROFIT SHARING PLAN 2009 363780199 2010-07-19 ELGIN FAMILY PHYSICIANS, S. C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8478883661
Plan sponsor’s address 915 CENTER STREET, SUITE 3000, ELGIN, IL, 60120

Plan administrator’s name and address

Administrator’s EIN 363780199
Plan administrator’s name ELGIN FAMILY PHYSICIANS, S. C.
Plan administrator’s address 915 CENTER STREET, SUITE 3000, ELGIN, IL, 60120
Administrator’s telephone number 8478883661

Signature of

Role Plan administrator
Date 2010-07-19
Name of individual signing DR. DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-19
Name of individual signing DR. DOROTHEA POULOS
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DOROTHEA POULOS, 87 N AIRLITE ST STE 130, ELGIN, 60123, KANE Agent 2019-01-14

President

Name and Address Role
DOROTHEA POULOS, 255 BROOKSIDEELGIN 60123 President

Secretary

Name and Address Role
DOROTHEA POULOS Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100 1000 No data

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State