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  5. TRI-CITIES SURGERY CENTER, LLC

TRI-CITIES SURGERY CENTER, LLC

Company Details

Entity Name: TRI-CITIES SURGERY CENTER, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Voluntary Diss./Terminated
Date Formed: 21 Jan 2004
Company Number: LLC_01095773
File Number: 01095773
Type of Management: Manager Managed
Date Status Change: 31 Aug 2017
Address 345 DELNOR DRIVE, GENEVA, 60134, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TRI-CITIES SURGERY CENTER LLC 401(K) PROFIT SHARING PLAN & TRUST 2017 510551673 2018-08-30 TRI-CITIES SURGERY CENTER LLC 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6302628100
Plan sponsor’s address 345 DELNOR DRIVE, GENEVA, IL, 601344220

Signature of
Role Plan administrator
Date 2018-08-30
Name of individual signing MICHAEL VIVODA
Valid signature Filed with authorized/valid electronic signature
TRI-CITIES SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2016 510551673 2017-06-05 TRI-CITIES SURGERY CENTER LLC 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6309383103
Plan sponsor’s address 345 DELNOR DR, GENEVA, IL, 601344220

Signature of
Role Plan administrator
Date 2017-06-05
Name of individual signing JOSEPH G. OLLAYOS
Valid signature Filed with authorized/valid electronic signature
TRI-CITIES SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2015 510551673 2016-05-12 TRI-CITIES SURGERY CENTER LLC 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6302628100
Plan sponsor’s address 345 DELNOR DR, GENEVA, IL, 601344220

Signature of
Role Plan administrator
Date 2016-05-12
Name of individual signing JOSEPH G. OLLAYOS
Valid signature Filed with authorized/valid electronic signature
TRI-CITIES SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2014 510551673 2015-06-25 TRI-CITIES SURGERY CENTER LLC 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6302628100
Plan sponsor’s address 345 DELNOR DR, GENEVA, IL, 601344220

Signature of
Role Plan administrator
Date 2015-06-25
Name of individual signing JOSEPH G. OLLAYOS
Valid signature Filed with authorized/valid electronic signature
TRI-CITIES SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2013 510551673 2014-07-18 TRI-CITIES SURGERY CENTER LLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6302628100
Plan sponsor’s address 345 DELNOR DR, GENEVA, IL, 601344220

Signature of
Role Plan administrator
Date 2014-07-18
Name of individual signing JOSEPH G. OLLAYOS
Valid signature Filed with authorized/valid electronic signature
TRI-CITIES SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2012 510551673 2013-06-04 TRI-CITIES SURGERY CENTER LLC 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6302628100
Plan sponsor’s address 345 DELNOR DR, GENEVA, IL, 601344220

Signature of
Role Plan administrator
Date 2013-06-04
Name of individual signing TRI-CITIES SURGERY CENTER LLC
Valid signature Filed with authorized/valid electronic signature
TRI-CITIES SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2011 510551673 2012-05-23 TRI-CITIES SURGERY CENTER LLC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6302628100
Plan sponsor’s address 345 DELNOR DR, GENEVA, IL, 601344220

Plan administrator’s name and address
Administrator’s EIN 510551673
Plan administrator’s name TRI-CITIES SURGERY CENTER LLC
Plan administrator’s address 345 DELNOR DR, GENEVA, IL, 601344220
Administrator’s telephone number 6302628100

Signature of
Role Plan administrator
Date 2012-05-23
Name of individual signing TRI-CITIES SURGERY CENTER LLC
Valid signature Filed with authorized/valid electronic signature
TRI-CITIES SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2010 510551673 2011-05-18 TRI-CITIES SURGERY CENTER LLC 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6302628100
Plan sponsor’s address 345 DELNOR AVE, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 510551673
Plan administrator’s name TRI-CITIES SURGERY CENTER LLC
Plan administrator’s address 345 DELNOR AVE, GENEVA, IL, 60134
Administrator’s telephone number 6302628100

Signature of
Role Plan administrator
Date 2011-05-18
Name of individual signing TRI-CITIES SURGERY CENTER LLC
Valid signature Filed with authorized/valid electronic signature
TRI-CITIES SURGERY CENTER LLC 2009 510551673 2010-06-17 TRI-CITIES SURGERY CENTER LLC 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621493
Sponsor’s telephone number 6302628100
Plan sponsor’s address 345 DELNOR AVE, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 510551673
Plan administrator’s name TRI-CITIES SURGERY CENTER LLC
Plan administrator’s address 345 DELNOR AVE, GENEVA, IL, 60134
Administrator’s telephone number 6302628100

Signature of
Role Plan administrator
Date 2010-06-17
Name of individual signing TRI-CITIES SURGERY CENTER LLC
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DANAE K. PROUSIS, 211 E. ONTARIO ST., STE 1800, CHICAGO, 60611, KANE Agent 2017-06-07

Manager

Name and Address Role Appointment Date
ARDELL, NANCY, 25 NORTH WINFIELD ROAD, WINFIELD, IL, 60190 Manager 2014-12-12
BRYANT,MAUREEN M.D., 300 RANDALL RD, GENEVA, IL, 60134 Manager 2016-01-11
DANIELS, MARK, 300 RANDALL ROAD, GENEVA, IL, 60134 Manager 2014-12-12

Related by officers

DANAE K. PROUSIS, 211 E. ONTARIO ST., STE 1800, CHICAGO, 60611, KANE

TRI-CITIES IMMEDIATE CARE, LLC

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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