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  5. PULMONARY FIBROSIS FOUNDATION

PULMONARY FIBROSIS FOUNDATION

Branch

Company Details

Entity Name: PULMONARY FIBROSIS FOUNDATION
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 20 Sep 2002
Branch of: PULMONARY FIBROSIS FOUNDATION, COLORADO (Company Number 20001172982)
Company Number: CORP_62464968
File Number: 62464968
Type of Business: Not for Profit
Address 811 W EVERGREEN AVE 2ND 204, CHICAGO, IL, 60642
Place of Formation: COLORADO

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PFF SAVINGS PLAN 2023 841558631 2024-04-05 PULMONARY FIBROSIS FOUNDATION 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 500, CHICAGO, IL, 60611
PFF SAVINGS PLAN 2022 841558631 2023-07-25 PULMONARY FIBROSIS FOUNDATION 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 500, CHICAGO, IL, 60611
PFF SAVINGS PLAN 2021 841558631 2022-08-26 PULMONARY FIBROSIS FOUNDATION 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 500, CHICAGO, IL, 60611

Signature of
Role Plan administrator
Date 2022-08-26
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-08-26
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature
PFF SAVINGS PLAN 2020 841558631 2021-07-20 PULMONARY FIBROSIS FOUNDATION 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 500, CHICAGO, IL, 60611

Signature of
Role Plan administrator
Date 2021-07-20
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY FIBROSIS FOUNDATION 2019 841558631 2020-10-06 PULMONARY FIBROSIS FOUNDATION 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 500, CHICAGO, IL, 60611

Signature of
Role Plan administrator
Date 2020-10-06
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY FIBROSIS FOUNDATION 2018 841558631 2019-07-24 PULMONARY FIBROSIS FOUNDATION 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 500, CHICAGO, IL, 60611

Signature of
Role Plan administrator
Date 2019-07-24
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY FIBROSIS FOUNDATION 2017 841558631 2018-07-19 PULMONARY FIBROSIS FOUNDATION 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 500, CHICAGO, IL, 60611

Signature of
Role Plan administrator
Date 2018-07-19
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY FIBROSIS FOUNDATION 2016 841558631 2017-06-02 PULMONARY FIBROSIS FOUNDATION 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 500, CHICAGO, IL, 60611

Signature of
Role Plan administrator
Date 2017-06-02
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY FIBROSIS FOUNDATION 2015 841558631 2016-07-29 PULMONARY FIBROSIS FOUNDATION 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 304, CHICAGO, IL, 60611

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY FIBROSIS FOUNDATION 2014 841558631 2015-10-10 PULMONARY FIBROSIS FOUNDATION 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 8887336741
Plan sponsor’s address 230 E. OHIO STREET, SUITE 304, CHICAGO, IL, 60611

Signature of
Role Plan administrator
Date 2015-10-10
Name of individual signing SCOTT STASZAK
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SCOTT ALLAN STASZAK, 230 E OHIO ST, STE 500, CHICAGO, 60611, COOK-NOT IN CITY OF CHICAGO Agent 2016-10-18

Director

Name and Address Role Account Number
LEANNE STORCH Director 314920

Secretary

Name and Address Role Account Number
JOSEPH BORUS Secretary 314920

President

Name and Address Role Account Number
DANIEL ROSE MD President 314920

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
BUSINESS LICENSE 2064966 Issued 1010 Limited Business License No data 2012-09-28 2012-11-16 2014-11-15
BUSINESS LICENSE 1803347 Issued 1010 Limited Business License No data 2008-10-21 2008-11-16 2010-11-15

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State

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