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  5. FAMILY HEALTH CENTER PHYSICIANS, LTD.

FAMILY HEALTH CENTER PHYSICIANS, LTD.

Company Details

Entity Name: FAMILY HEALTH CENTER PHYSICIANS, LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 19 Feb 2003
Date of Dissolution: 27 Jan 2015
Company Number: CORP_62654945
File Number: 62654945
Type of Business: Incorporated under the Medical Corporation Act
Date Status Change: 27 Jan 2015
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY HEALTH CENTER PHYSICIANS, LTD. RETIREMENT PLAN 2012 010768964 2013-08-12 FAMILY HEALTH CENTER PHYSICIANS, LTD. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 8154698803
Plan sponsor’s address 1105 SWINFORD LANE, MOKENA, IL, 60448

Plan administrator’s name and address
Administrator’s EIN 010768964
Plan administrator’s name FAMILY HEALTH CENTER PHYSICIANS, LTD.
Plan administrator’s address 1105 SWINFORD LANE, MOKENA, IL, 60448
Administrator’s telephone number 8154698803

Signature of
Role Plan administrator
Date 2013-08-12
Name of individual signing SUSAN DALY
Valid signature Filed with authorized/valid electronic signature
FAMILY HEALTH CENTER PHYSICIANS, LTD. RETIREMENT PLAN 2012 010768964 2013-09-27 FAMILY HEALTH CENTER PHYSICIANS, LTD. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 8154698803
Plan sponsor’s address 1105 SWINFORD LANE, MOKENA, IL, 60448

Plan administrator’s name and address
Administrator’s EIN 010768964
Plan administrator’s name FAMILY HEALTH CENTER PHYSICIANS, LTD.
Plan administrator’s address 1105 SWINFORD LANE, MOKENA, IL, 60448
Administrator’s telephone number 8154698803

Signature of
Role Plan administrator
Date 2013-09-27
Name of individual signing SUSAN DALY
Valid signature Filed with authorized/valid electronic signature
FAMILY HEALTH CENTER PHYSICIANS, LTD. RETIREMENT PLAN 2011 010768964 2012-08-29 FAMILY HEALTH CENTER PHYSICIANS, LTD. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 8154698803
Plan sponsor’s address 1105 SWINFORD LANE, MOKENA, IL, 60448

Plan administrator’s name and address
Administrator’s EIN 010768964
Plan administrator’s name FAMILY HEALTH CENTER PHYSICIANS, LTD.
Plan administrator’s address 1105 SWINFORD LANE, MOKENA, IL, 60448
Administrator’s telephone number 8154698803

Signature of
Role Plan administrator
Date 2012-08-29
Name of individual signing SUSAN DALY
Valid signature Filed with authorized/valid electronic signature
FAMILY HEALTH CENTER PHYSICIANS, LTD. RETIREMENT PLAN 2010 010768964 2011-07-27 FAMILY HEALTH CENTER PHYSICIANS, LTD. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 8154698803
Plan sponsor’s address 1105 SWINFORD LANE, MOKENA, IL, 60448

Plan administrator’s name and address
Administrator’s EIN 010768964
Plan administrator’s name FAMILY HEALTH CENTER PHYSICIANS, LTD.
Plan administrator’s address 1105 SWINFORD LANE, MOKENA, IL, 60448
Administrator’s telephone number 8154698803

Signature of
Role Plan administrator
Date 2011-07-26
Name of individual signing JEROME T. DALY
Valid signature Filed with authorized/valid electronic signature
FAMILY HEALTH CENTER PHYSICIANS, LTD. RETIREMENT PLAN 2009 010768964 2010-09-17 FAMILY HEALTH CENTER PHYSICIANS, LTD. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-07-01
Business code 621111
Sponsor’s telephone number 8154698803
Plan sponsor’s address 11501 SWINFORD LANE, MOKENA, IL, 60448

Plan administrator’s name and address
Administrator’s EIN 010768964
Plan administrator’s name FAMILY HEALTH CENTER PHYSICIANS, LTD.
Plan administrator’s address 11501 SWINFORD LANE, MOKENA, IL, 60448
Administrator’s telephone number 8154698803

Signature of
Role Plan administrator
Date 2010-09-16
Name of individual signing JEROME T. DALY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-16
Name of individual signing JEROME T. DALY
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MARY LOUISE KANDYBA, 55 W MONROE ST SUITE 1600, CHICAGO, 60603, COOK-NOT IN CITY OF CHICAGO Agent 2007-12-20

President

Name and Address Role
JEROME T DALY D O, 11501 SWINFORD LANE MOKENA 60448 President

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
MEDICAL CORP 042617934 No data No data REGISTERED MEDICAL CORPORATION No data 2003-05-23 2010-09-20 2012-01-01

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100000 15000000 No data

Related by officers

MARY LOUISE KANDYBA, 55 W MONROE ST SUITE 1600, CHICAGO, 60603, COOK-NOT IN CITY OF CHICAGO

J.S. DALY, 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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