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  5. JANICE TAKATA-ROSSI, M.D., S.C.

JANICE TAKATA-ROSSI, M.D., S.C.

Company Details

Entity Name: JANICE TAKATA-ROSSI, M.D., S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 17 Apr 2002
Company Number: CORP_62171448
File Number: 62171448
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
JANICE TAKATA- ROSSI, M.D., S.C. S.H. PLAN 2021 352166442 2022-06-29 JANICE TAKATA-ROSSI, M.D., S.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2022-06-29
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-29
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
JANICE TAKATA- ROSSI, M.D., S.C. S.H. PLAN 2021 352166442 2022-09-06 JANICE TAKATA-ROSSI, M.D., S.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2022-09-06
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-06
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
JANICE TAKATA- ROSSI, M.D., S.C. S.H. PLAN 2020 352166442 2021-05-17 JANICE TAKATA-ROSSI, M.D., S.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2021-05-17
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-17
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
JANICE TAKATA- ROSSI, M.D., S.C. S.H. PLAN 2019 352166442 2020-05-22 JANICE TAKATA-ROSSI, M.D., S.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2020-05-22
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-05-22
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
JANICE TAKATA- ROSSI, M.D., S.C. S.H. PLAN 2018 352166442 2019-09-18 JANICE TAKATA-ROSSI, M.D., S.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2019-09-18
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
JANICE TAKATA- ROSSI, M.D., S.C. S.H. PLAN 2017 352166442 2018-04-27 JANICE TAKATA-ROSSI, M.D., S.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2018-04-27
Name of individual signing NATHAN ISENBERG
Valid signature Filed with authorized/valid electronic signature
JANICE TAKATA- ROSSI, M.D., S.C. S.H. PLAN 2016 352166442 2017-07-07 JANICE TAKATA-ROSSI, M.D., S.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2017-07-07
Name of individual signing JANICE TAKATA-ROSSI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-07
Name of individual signing JANICE TAKATA-ROSSI
Valid signature Filed with authorized/valid electronic signature
JANICE TAKATA- ROSSI, M.D., S.C. S.H. PLAN 2015 352166442 2016-07-22 JANICE TAKATA-ROSSI, M.D., S.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2016-07-22
Name of individual signing JANICE TAKATA-ROSSI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-22
Name of individual signing JANICE TAKATA-ROSSI
Valid signature Filed with authorized/valid electronic signature
JANICE TAKATA ROSSI, M.D., S.C. S.H. PLAN 2014 352166442 2015-06-24 JANICE TAKATA ROSSI, M.D., S.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-12-01
Business code 621111
Sponsor’s telephone number 8007476453
Plan sponsor’s address 1600 SOUTH FOURTH, SUITE 140, MORTON, IL, 61550

Signature of
Role Plan administrator
Date 2015-06-24
Name of individual signing JANICE TAKATA ROSSI M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-24
Name of individual signing JANICE TAKATA ROSSI M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
KENNETH R EATHINGTON, 227 NE JEFFERSON AVE, PEORIA, 61602, PEORIA Agent 2018-04-04

President

Name and Address Role
JANICE TAKATA ROSSI 465 S GREENWOOD ST MORTON 61550 President

Secretary

Name and Address Role
JANICE TAKATA ROSSI Secretary

Shares

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

Related by officers

KENNETH R EATHINGTON, 227 NE JEFFERSON AVE, PEORIA, 61602, PEORIA

ASSOCIATED ORAL AND MAXILLOFACIAL SURGEONS OF PEORIA, LTD. VANBUSKIRK CONSTRUCTION COMPANY CENTRAL ILLINOIS DERMATOLOGY, S.C. LISTON ENTERPRISES, INC. MIDWEST EAR, NOSE & THROAT ASSOCIATES, S.C. DICARO ENTERPRISES, INC. SAB07, LLC MIDWEST HEARING CENTER, INC. MROP, INC. UNIVERSAL PROCUREMENTS CORPORATION

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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