| Entity Name: | A & D MEDICAL CENTER, S.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 22 Nov 2004 |
| Date of Dissolution: | 10 Apr 2015 |
| Company Number: | CORP_63900656 |
| File Number: | 63900656 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Date Status Change: | 10 Apr 2015 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A & D MEDICAL CENTER SAFE HARBOR 401K PSP | 2010 | 202036672 | 2010-11-03 | A & D MEDICAL CENTER S.C. | 2 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 202036672 |
| Plan administrator’s name | A & D MEDICAL CENTER S.C. |
| Plan administrator’s address | 64 N ALFRED AVENUE, SUITE B, ELGIN, IL, 60123 |
| Administrator’s telephone number | 7733439844 |
Signature of
| Role | Plan administrator |
| Date | 2010-11-03 |
| Name of individual signing | JAWED EHSAN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7733439844 |
| Plan sponsor’s address | 64 N ALFRED AVENUE, SUITE B, ELGIN, IL, 60123 |
Plan administrator’s name and address
| Administrator’s EIN | 202036672 |
| Plan administrator’s name | A & D MEDICAL CENTER S.C. |
| Plan administrator’s address | 64 N ALFRED AVENUE, SUITE B, ELGIN, IL, 60123 |
| Administrator’s telephone number | 7733439844 |
Signature of
| Role | Plan administrator |
| Date | 2010-08-19 |
| Name of individual signing | JAWED EHSAN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| JAWED EHSAN, 380 SUMMIT AVE, ELGIN, 60120, COOK-NOT IN CITY OF CHICAGO | Agent | 2012-06-22 |
| Name and Address | Role |
|---|---|
| JAWED EHSAN 380 SUMMIT AVE ELGIN IL 60120 | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 100000 | 10000000 | No data |
Date of last update: 27 Jan 2025
