| Entity Name: | MID-ILLINOIS MEDICAL CARE ASSOCIATES, L.L.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | NGS |
| Date Formed: | 08 Dec 1999 |
| Company Number: | LLC_00348104 |
| File Number: | 00348104 |
| Type of Management: | Manager Managed |
| Date Status Change: | 01 Dec 2024 |
| Expiration Date: | 31 Dec 2035 |
| Address | 1207 NETWORK CENTRE DRIVE, #3, EFFINGHAM, 62401, IL |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MID-ILLINOIS MEDICAL CARE ASSOCIATES MEDOVA LIFESTYLE HEALTH PLAN | 2022 | 371391171 | 2024-08-28 | MID-ILLINOIS MEDICAL CARE ASSOCIATES | 0 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 200200514 |
| Plan administrator’s name | RECEIVERSHIP MANAGEMENT, INC. |
| Plan administrator’s address | 510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number | 6153700051 |
Signature of
| Role | Plan administrator |
| Date | 2024-08-28 |
| Name of individual signing | ROBERT MOORE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2021-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2173472707 |
| Plan sponsor’s address | 1207 NETWORK CENTRE DR STE 3, EFFINGHAM, IL, 624014632 |
Plan administrator’s name and address
| Administrator’s EIN | 200200514 |
| Plan administrator’s name | RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s address | 510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number | 6153700051 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-28 |
| Name of individual signing | ROBERT MOORE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| ERIC A. BLOEMER, 206 N. PEARL ST., TEUTOPOLIS, 62467 | Agent | 2019-11-26 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| MICHELLE R. BRADDY, 203 S MAIN ST, DIETERICH, IL, 62424 | Manager | 2011-11-16 |
| ANDREW GAGE, 512 N MAPLE ST SUITE 200, EFFINGHAM, IL, 62401 | Manager | 2017-11-22 |
| MERKEL M.D., JOHN U, 206 N PEARL, TEUTOPOLIS, IL, 62467 | Manager | 2007-10-22 |
| RUNDE M.D., CHARLES W, 206 N PEARL, TEUTOPOLIS, IL, 62467 | Manager | 2007-10-22 |
| ERIC A. BLOEMER, 206 NORTH PEARL ST., TEUTOPOLIS, IL, 62467 | Manager | 2014-11-05 |
Date of last update: 13 Jan 2025
