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  5. INNOVATIVE SPINE SOLUTIONS, LTD.

INNOVATIVE SPINE SOLUTIONS, LTD.

Company Details

Entity Name: INNOVATIVE SPINE SOLUTIONS, LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 26 Sep 2011
Company Number: CORP_68132134
File Number: 68132134
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INNOVATIVE SPINE SOLUTIONS, LTD. 401(K) PLAN 2020 453436309 2021-07-14 INNOVATIVE SPINE SOLUTIONS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 446190
Sponsor’s telephone number 8473582485
Plan sponsor’s address 441 AYRSHIRE LANE, INVERNESS, IL, 60067

Signature of
Role Plan administrator
Date 2021-07-14
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-14
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
INNOVATIVE SPINE SOLUTIONS, LTD. 401(K) PLAN 2020 453436309 2021-07-14 INNOVATIVE SPINE SOLUTIONS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 446190
Sponsor’s telephone number 8473582485
Plan sponsor’s address 441 AYRSHIRE LANE, INVERNESS, IL, 60067

Signature of
Role Plan administrator
Date 2021-07-14
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-14
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
INNOVATIVE SPINE SOLUTIONS, LTD. 401(K) PLAN 2019 453436309 2020-07-24 INNOVATIVE SPINE SOLUTIONS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 446190
Sponsor’s telephone number 8473582485
Plan sponsor’s address 441 AYRSHIRE LANE, INVERNESS, IL, 60067

Signature of
Role Plan administrator
Date 2020-07-24
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-24
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
INNOVATIVE SPINE SOLUTIONS, LTD. 401(K) PLAN 2018 453436309 2019-07-30 INNOVATIVE SPINE SOLUTIONS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 446190
Sponsor’s telephone number 8473582485
Plan sponsor’s address 166 S BOTHWELL STREET, PALATINE, IL, 60067

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-30
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
INNOVATIVE SPINE SOLUTIONS, LTD. 401(K) PLAN 2017 453436309 2018-07-27 INNOVATIVE SPINE SOLUTIONS, LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 446190
Sponsor’s telephone number 8473582485
Plan sponsor’s address 166 S BOTHWELL STREET, PALATINE, IL, 60067

Signature of
Role Plan administrator
Date 2018-07-27
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-27
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
INNOVATIVE SPINE SOLUTIONS, LTD. 401(K) PLAN 2016 453436309 2017-07-17 INNOVATIVE SPINE SOLUTIONS, LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 446190
Sponsor’s telephone number 8473582485
Plan sponsor’s address 166 S BOTHWELL STREET, PALATINE, IL, 60067

Signature of
Role Plan administrator
Date 2017-07-16
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature
INNOVATIVE SPINE SOLUTIONS, LTD. 401(K) PLAN 2015 453436309 2016-07-29 INNOVATIVE SPINE SOLUTIONS, LTD. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 446190
Sponsor’s telephone number 8473582485
Plan sponsor’s address 166 S BOTHWELL STREET, PALATINE, IL, 60067

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing BERNICE GIEBELHAUS
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
BERNICE GIEBELHAUS, 441 AYSHIRE LANE, INVERNESS, 60067, COOK-NOT IN CITY OF CHICAGO Agent 2023-12-08

President

Name and Address Role
CHRISTOPHER J GIEBELHAUS, 441AYRSHIRE LN, INVERNESS 60067 President

Secretary

Name and Address Role
BERNICE A GIEBELHAUS Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100000 1000000 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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