| Entity Name: | MADISON COUNTY INTERNISTS, P.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 13 Mar 2003 |
| Date of Dissolution: | 10 Aug 2007 |
| Company Number: | CORP_62746327 |
| File Number: | 62746327 |
| Type of Business: | Incorporated under the Professional Service Corporation Act |
| Date Status Change: | 10 Aug 2007 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MADISON COUNTY INTERNISTS, P.C. 401K PROFIT SHARING PLAN | 2010 | 061682375 | 2011-02-14 | MADISON COUNTY INTERNISTS, P.C. | 1 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 061682375 |
| Plan administrator’s name | MADISON COUNTY INTERNISTS, P.C. |
| Plan administrator’s address | 2044 MADISON AVE STE 15, GRANITE CITY, IL, 620404641 |
| Administrator’s telephone number | 6184511500 |
Signature of
| Role | Plan administrator |
| Date | 2011-02-14 |
| Name of individual signing | DR. KEVIN KONZEN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2004-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 6184511500 |
| Plan sponsor’s address | 2044 MADISON AVE STE 15, GRANITE CITY, IL, 620404641 |
Plan administrator’s name and address
| Administrator’s EIN | 061682375 |
| Plan administrator’s name | MADISON COUNTY INTERNISTS, P.C. |
| Plan administrator’s address | 2044 MADISON AVE STE 15, GRANITE CITY, IL, 620404641 |
| Administrator’s telephone number | 6184511500 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-12 |
| Name of individual signing | DR. KEVIN KONZEN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| KEVIN KONZEN, 2044 MADISON ST STE 15, GRANITE CITY, 62040, MADISON | Agent | 2004-06-15 |
| Name and Address | Role |
|---|---|
| KEVIN KONZEN, 2044 MADISON AVE, GRANITE CITY IL 62040 | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 50000 | 5000000 | 1 |
Date of last update: 27 Jan 2025
