| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
2004-01-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
8474291157
|
| Plan
sponsor’s DBA name |
PEDIATRIC AND NEONATAL SERVICES
|
| Plan sponsor’s mailing address |
901 CENTER ST., SUITE 209, ELGIN, IL, 601202120
|
| Plan sponsor’s
address |
901 CENTER ST., SUITE 209, ELGIN, IL, 601202120
|
Plan administrator’s name and address
| Administrator’s EIN |
743111297 |
| Plan administrator’s name |
GEETI GHOSH, M.D.S.C. |
| Plan administrator’s
address |
901 CENTER ST., SUITE 209, ELGIN, IL, 601202120 |
| Administrator’s telephone number |
8474291157 |
Number of participants as of the end of the plan year
| Active participants |
2 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-07-21 |
| Name of individual signing |
RONALD WILLOUR |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
