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  5. LISA J. PETERS, M.D., S.C.

LISA J. PETERS, M.D., S.C.

Company Details

Entity Name: LISA J. PETERS, M.D., S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 03 Nov 2003
Company Number: CORP_63178055
File Number: 63178055
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
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2023 200360578 2024-08-30 LISA J. PETERS, M.D., S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 7236 MADISON STREET, FOREST PARK, IL, 60130

Signature of
Role Plan administrator
Date 2024-08-30
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-08-30
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2022 200360578 2023-09-29 LISA J. PETERS, M.D., S.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 7236 MADISON STREET, FOREST PARK, IL, 60130

Signature of
Role Plan administrator
Date 2023-09-29
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-29
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2021 200360578 2022-10-11 LISA J. PETERS, M.D., S.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 7236 MADISON STREET, FOREST PARK, IL, 60130

Signature of
Role Plan administrator
Date 2022-10-11
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-11
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2020 200360578 2021-10-11 LISA J. PETERS, M.D., S.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 1010 LAKE STREET, SUITE 619, OAK PARK, IL, 60301

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-11
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2019 200360578 2020-08-31 LISA J. PETERS, M.D., S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 1010 LAKE STREET, SUITE 619, OAK PARK, IL, 60301

Signature of
Role Plan administrator
Date 2020-08-31
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-31
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2018 200360578 2019-10-04 LISA J. PETERS, M.D., S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 1010 LAKE STREET, SUITE 619, OAK PARK, IL, 60301

Signature of
Role Plan administrator
Date 2019-10-04
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-04
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2017 202360578 2018-10-08 LISA J. PETERS, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 1010 LAKE STREET, SUITE 619, OAK PARK, IL, 60301

Signature of
Role Plan administrator
Date 2018-10-08
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-08
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2016 202360578 2017-08-31 LISA J. PETERS, M.D., S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 1010 LAKE STREET, SUITE 619, OAK PARK, IL, 60301

Signature of
Role Plan administrator
Date 2017-08-31
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-31
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2015 202360578 2016-04-18 LISA J. PETERS, M.D., S.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 1010 LAKE STREET, SUITE 619, OAK PARK, IL, 60301

Signature of
Role Plan administrator
Date 2016-04-18
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-18
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
LISA J. PETERS, M.D., S.C. PROFIT SHARING PLAN 2014 202360578 2015-03-20 LISA J. PETERS, M.D., S.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 7085241400
Plan sponsor’s address 1010 LAKE STREET, SUITE 619, OAK PARK, IL, 60301

Signature of
Role Plan administrator
Date 2015-03-20
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-20
Name of individual signing LISA PETERS
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
TFA REGISTERED AGENT CORPORATION, 549 S WASHINGTON ST, NAPERVILLE, 60540, DU PAGE Agent 2022-08-30

President

Name and Address Role
LISA J. PETERS MD 7236 MADISONSTREET FOREST PARK IL 60130 President

Secretary

Name and Address Role
LISA J. PETERS MD 7236 MADISONSTREET FOREST PARK IL 60130 Secretary

Shares

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

Related by officers

TFA REGISTERED AGENT CORPORATION, 549 S WASHINGTON ST, NAPERVILLE, 60540, DU PAGE

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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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