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  5. SUJATHA RAO, M.D., P.C.

SUJATHA RAO, M.D., P.C.

Company Details

Entity Name: SUJATHA RAO, M.D., P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 08 Jul 2004
Date of Dissolution: 14 Dec 2018
Company Number: CORP_63673749
File Number: 63673749
Type of Business: Incorporated under the Professional Service Corporation Act
Date Status Change: 14 Dec 2018
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SUJATHA RAO, M.D., P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2015 201307515 2016-02-16 SUJATHA RAO, M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6185290120
Plan sponsor’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901

Signature of
Role Plan administrator
Date 2016-02-16
Name of individual signing SUJATHA RAO, MD
Valid signature Filed with authorized/valid electronic signature
SUJATHA RAO, M.D., P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2014 201307515 2015-05-14 SUJATHA RAO, M.D., P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6185290120
Plan sponsor’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901

Signature of
Role Plan administrator
Date 2015-05-14
Name of individual signing SUJATHA RAO MD
Valid signature Filed with authorized/valid electronic signature
SUJATHA RAO, M.D., P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2013 201307515 2014-05-16 SUJATHA RAO, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6185290120
Plan sponsor’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901

Signature of
Role Plan administrator
Date 2014-05-16
Name of individual signing SUJATHA RAO MD
Valid signature Filed with authorized/valid electronic signature
SUJATHA RAO, M.D., P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2013 201307515 2014-05-16 SUJATHA RAO, M.D., P.C. 9
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6185290120
Plan sponsor’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901

Signature of
Role Plan administrator
Date 2014-05-16
Name of individual signing SUJATHA RAO MD
Valid signature Filed with authorized/valid electronic signature
SUJATHA RAO, M.D., P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2012 201307515 2013-07-17 SUJATHA RAO, M.D., P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6185290120
Plan sponsor’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901

Signature of
Role Plan administrator
Date 2013-07-17
Name of individual signing SUJATHA RAO MD
Valid signature Filed with authorized/valid electronic signature
SUJATHA RAO, M.D., P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2011 201307515 2012-07-26 SUJATHA RAO, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6185290120
Plan sponsor’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901

Plan administrator’s name and address
Administrator’s EIN 201307515
Plan administrator’s name SUJATHA RAO, M.D., P.C.
Plan administrator’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901
Administrator’s telephone number 6185290120

Signature of
Role Plan administrator
Date 2012-07-26
Name of individual signing SUJATHA RAO MD
Valid signature Filed with authorized/valid electronic signature
SUJATHA RAO, M.D., P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2010 201307515 2011-05-26 SUJATHA RAO, M.D., P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6185290120
Plan sponsor’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901

Plan administrator’s name and address
Administrator’s EIN 201307515
Plan administrator’s name SUJATHA RAO, M.D., P.C.
Plan administrator’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901
Administrator’s telephone number 6185290120

Signature of
Role Plan administrator
Date 2011-05-26
Name of individual signing SUJATHA RAO MD
Valid signature Filed with authorized/valid electronic signature
SUJATHA RAO, M.D., P.C. SAFE HARBOR 401(K) PROFIT SHARING PLAN 2009 201307515 2010-07-26 SUJATHA RAO, M.D., P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6185290120
Plan sponsor’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901

Plan administrator’s name and address
Administrator’s EIN 201307515
Plan administrator’s name SUJATHA RAO, M.D., P.C.
Plan administrator’s address 1390 HOPE DRIVE, CARBONDALE, IL, 62901
Administrator’s telephone number 6185290120

Signature of
Role Plan administrator
Date 2010-07-26
Name of individual signing SUJATHA RAO MD
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SRINIVAS V GUNDALA, 1390 HOPE DR, STE, 1, CARBONDALE, 62901, JACKSON Agent 2007-11-29

President

Name and Address Role
SUJATHA RAO 3255 CINNABAR POINT CARBONDALE 62901 President

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
HEM-ONC CARE No data 2004-09-28 2018-12-01 Involuntary Cancellation No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 500000 No data

Related by officers

No related officers

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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