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  5. LIFECARE INNOVATIONS, INC.

LIFECARE INNOVATIONS, INC.

Company Details

Entity Name: LIFECARE INNOVATIONS, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Merged/Consolidated
Date Formed: 14 Jul 2009
Company Number: CORP_66976831
File Number: 66976831
Type of Business: All Inclusive Purpose
Date Status Change: 31 Dec 2014
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LIFECARE INNOVATIONS 401(K) PLAN 2020 204211296 2021-04-08 LIFECARE INNOVATIONS, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 624100
Sponsor’s telephone number 6309532154
Plan sponsor’s address 8330 SOUTH MADISON STREET SUITE 90, BURR RIDGE, IL, 605276595

Signature of
Role Plan administrator
Date 2021-04-08
Name of individual signing LAUREN SHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-08
Name of individual signing LAUREN SHERMAN
Valid signature Filed with authorized/valid electronic signature
LIFECARE INNOVATIONS, INC. 401(K) PLAN 2019 204211296 2020-07-27 LIFECARE INNOVATIONS, INC. 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 624100
Sponsor’s telephone number 6309532154
Plan sponsor’s address 8330 SOUTH MADISON STREET SUITE 90, BURR RIDGE, IL, 605276595

Signature of
Role Plan administrator
Date 2020-07-27
Name of individual signing LAUREN SHERMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-27
Name of individual signing LAUREN SHERMAN
Valid signature Filed with authorized/valid electronic signature
LIFECARE INNOVATIONS, INC. 401(K) PLAN 2013 061436202 2014-09-11 LIFECARE INNOVATIONS, INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 624100
Sponsor’s telephone number 6309532154
Plan sponsor’s address 8330 S. MADISON STREET, SUITE 90, BURR RIDGE, IL, 60527

Signature of
Role Plan administrator
Date 2014-09-11
Name of individual signing SHAY JACOBSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-09-11
Name of individual signing SHAY JACOBSON
Valid signature Filed with authorized/valid electronic signature
LIFECARE INNOVATIONS, INC. 401(K) PLAN 2012 061436202 2013-09-26 LIFECARE INNOVATIONS, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 624100
Sponsor’s telephone number 6309532154
Plan sponsor’s address 8330 S. MADISON STREET, SUITE 90, BURR RIDGE, IL, 60527

Signature of
Role Plan administrator
Date 2013-09-25
Name of individual signing SHAY JACOBSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-25
Name of individual signing SHAY JACOBSON
Valid signature Filed with authorized/valid electronic signature
LIFECARE INNOVATIONS, INC. 401(K) PLAN 2011 061436202 2012-10-08 LIFECARE INNOVATIONS, INC. 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 624100
Sponsor’s telephone number 6309532154
Plan sponsor’s address 8330 S. MADISON STREET, SUITE 90, BURR RIDGE, IL, 60527

Plan administrator’s name and address
Administrator’s EIN 061436202
Plan administrator’s name LIFECARE INNOVATIONS, INC.
Plan administrator’s address 8330 S. MADISON STREET, SUITE 90, BURR RIDGE, IL, 60527
Administrator’s telephone number 6309532154

Signature of
Role Plan administrator
Date 2012-10-08
Name of individual signing SHAY JACOBSON
Valid signature Filed with authorized/valid electronic signature
LIFECARE INNOVATIONS, INC. 401(K) PLAN 2010 061436202 2011-09-07 LIFECARE INNOVATIONS, INC. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 624100
Sponsor’s telephone number 6309532154
Plan sponsor’s address ONE S. 450 SUMMIT AVENUE, SUITE 375, OAKBROOK TERRAC, IL, 60181

Plan administrator’s name and address
Administrator’s EIN 061436202
Plan administrator’s name LIFECARE INNOVATIONS, INC.
Plan administrator’s address ONE S. 450 SUMMIT AVENUE, SUITE 375, OAKBROOK TERRAC, IL, 60181
Administrator’s telephone number 6309532154

Signature of
Role Plan administrator
Date 2011-09-07
Name of individual signing SHAY JACOBSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SHAY JACOBSON, 8330 S MADISON STREET SUITE 90, BURR RIDGE, 60527, DU PAGE Agent 2011-06-07

President

Name and Address Role
SHAY JACOBSON 13809 S KI8NG RD HOMER GLEN 60491 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 2000000 942460000 0.001
PREFERRED A No Voting Rights 2000000 942460000 0.001

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State

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