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ERICKSON ORAL & MAXILLOFACIAL SURGERY LLC

Company Details

Entity Name: ERICKSON ORAL & MAXILLOFACIAL SURGERY LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 12 Dec 2001
Company Number: LLC_00638846
File Number: 00638846
Type of Management: Manager Managed
Date Status Change: 01 Dec 2024
Address 383 SCHMALE RD, CAROL STREAM, 60188, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2022 364487406 2023-10-19 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2023-10-19
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2022 364487406 2023-07-20 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2023-07-20
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2021 364487406 2022-07-29 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2022-07-29
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2020 364487406 2021-06-10 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2021-06-10
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2019 364487406 2020-09-14 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2020-09-14
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2018 364487406 2019-10-10 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2019-10-10
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2017 364487406 2018-07-27 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2018-07-27
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2016 364487406 2017-07-31 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2017-07-31
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-31
Name of individual signing PATTI MCCAULEY
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2015 364487406 2016-08-25 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2016-08-25
Name of individual signing MARK ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-25
Name of individual signing MARK ERICKSON
Valid signature Filed with authorized/valid electronic signature
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC RETIREMENT PLAN 2014 364487406 2015-09-29 ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 6309090500
Plan sponsor’s address 383 SCHMALE ROAD, CAROL STREAM, IL, 60188

Signature of

Role Plan administrator
Date 2015-09-29
Name of individual signing MARK ERICKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-29
Name of individual signing MARK ERICKSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MARK F. ERICKSON, 8685 TIMBER RIDGE DRIVE, BURR RIDGE, 60527, DU PAGE Agent 2022-06-16

Manager

Name and Address Role Appointment Date
ERICKSON D.D.S., MARK F, 383 SCHMALE RD, CAROL STREAM, IL, 60188 Manager 2024-12-01

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
PRAIRIE PATH ORAL SURGERY Assumed name 2022-06-24 No data No data No data

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State