Search icon

WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C.

Company Details

Entity Name: WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 16 Mar 2004
Company Number: CORP_63392421
File Number: 63392421
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
WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY 401(K) PSP 2023 020720473 2024-10-11 WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY,S.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-11-01
Business code 621399
Sponsor’s telephone number 6304438855
Plan sponsor’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174

Signature of

Role Plan administrator
Date 2024-10-11
Name of individual signing RANY JAZAYERLI
Valid signature Filed with authorized/valid electronic signature
WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 401(K) PROFIT-SHARING PLAN AND TRUST 2015 020720473 2017-01-19 WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-11-01
Business code 621399
Sponsor’s telephone number 6304438855
Plan sponsor’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174
WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 401(K) PROFIT-SHARING PLAN AND TRUST 2014 020720473 2016-02-16 WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-11-01
Business code 621399
Sponsor’s telephone number 6304438855
Plan sponsor’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174
WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 401(K) PROFIT-SHARING PLAN AND TRUST 2013 020720473 2015-05-07 WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-11-01
Business code 621399
Sponsor’s telephone number 6304438855
Plan sponsor’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174

Signature of

Role Plan administrator
Date 2015-05-07
Name of individual signing RANY JAZAYERLI
Valid signature Filed with authorized/valid electronic signature
WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 401(K) PROFIT-SHARING PLAN AND TRUST 2012 020720473 2014-02-18 WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-11-01
Business code 621399
Sponsor’s telephone number 6304438855
Plan sponsor’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174

Plan administrator’s name and address

Administrator’s EIN 020720473
Plan administrator’s name WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C.
Plan administrator’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174
Administrator’s telephone number 6304438855

Signature of

Role Plan administrator
Date 2014-02-18
Name of individual signing RANY JAZAYERLI
Valid signature Filed with authorized/valid electronic signature
WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 401(K) PROFIT-SHARING PLAN AND TRUST 2011 020720473 2013-07-22 WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-11-01
Business code 621399
Sponsor’s telephone number 6304438855
Plan sponsor’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174

Plan administrator’s name and address

Administrator’s EIN 020720473
Plan administrator’s name WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C.
Plan administrator’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174
Administrator’s telephone number 6304438855

Signature of

Role Plan administrator
Date 2013-07-22
Name of individual signing RANY JAZAYERLI
Valid signature Filed with authorized/valid electronic signature
WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 401(K) PROFIT-SHARING PLAN AND TRUST 2010 020720473 2012-02-22 WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-11-01
Business code 621399
Sponsor’s telephone number 6304438855
Plan sponsor’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174

Plan administrator’s name and address

Administrator’s EIN 020720473
Plan administrator’s name WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C.
Plan administrator’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174
Administrator’s telephone number 6304438855

Signature of

Role Plan administrator
Date 2012-02-22
Name of individual signing RANY JAZAYERLI
Valid signature Filed with authorized/valid electronic signature
WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 401(K) PROFIT-SHARING PLAN AND TRUST 2009 020720473 2011-05-12 WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-11-01
Business code 621399
Sponsor’s telephone number 6304438855
Plan sponsor’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174

Plan administrator’s name and address

Administrator’s EIN 020720473
Plan administrator’s name WEST SUBURBAN DERMATOLOGY AND COSMETIC SURGERY, S.C.
Plan administrator’s address 2560 FOXFIELD ROAD, SUITE 100, ST. CHARLES, IL, 60174
Administrator’s telephone number 6304438855

Signature of

Role Plan administrator
Date 2011-05-12
Name of individual signing RANY JAZAYERLI
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
RANY JAZAYERLI, MD, 2560 FOXFIELD RD STE 100, ST CHARLES, 60174, KANE Agent 2022-03-03

President

Name and Address Role
RANY JAZAYERLI MD (TR/DI) 2560FOXFIELD RD #100 ST CHARLES President

Secretary

Name and Address Role
60174 Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
CLEAR SKIN DERMATOLOGY Assume Name 2007-02-02 No data No data No data

Shares

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

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State