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  5. BRIGHAM ANESTHESIA SOUTH, LLC

BRIGHAM ANESTHESIA SOUTH, LLC

Company Details

Entity Name: BRIGHAM ANESTHESIA SOUTH, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Involuntary Dissolution
Date Formed: 31 Mar 2004
Company Number: LLC_01150723
File Number: 01150723
Type of Management: Manager Managed
Date Status Change: 08 Sep 2023
Address 35 ALBANY RD, STE C, CARBONDALE, 62901, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2018 201034336 2019-10-08 BRIGHAM ANESTHESIA SOUTH, LLC 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62903

Signature of
Role Plan administrator
Date 2019-10-08
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-08
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2017 201034336 2018-06-04 BRIGHAM ANESTHESIA SOUTH, LLC 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62903

Signature of
Role Plan administrator
Date 2018-06-04
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-04
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2016 201034336 2017-05-12 BRIGHAM ANESTHESIA SOUTH, LLC 58
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62903

Signature of
Role Plan administrator
Date 2017-05-12
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-12
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2015 201034336 2016-06-29 BRIGHAM ANESTHESIA SOUTH, LLC 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62903

Signature of
Role Plan administrator
Date 2016-06-29
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-29
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2014 201034336 2015-06-02 BRIGHAM ANESTHESIA SOUTH, LLC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62903

Signature of
Role Plan administrator
Date 2015-06-02
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-02
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2013 201034336 2014-03-19 BRIGHAM ANESTHESIA SOUTH, LLC 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62901

Signature of
Role Plan administrator
Date 2014-03-19
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-03-19
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2012 201034336 2013-06-25 BRIGHAM ANESTHESIA SOUTH, LLC 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62901

Signature of
Role Plan administrator
Date 2013-06-25
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-25
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2011 201034336 2012-04-04 BRIGHAM ANESTHESIA SOUTH, LLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62901

Plan administrator’s name and address
Administrator’s EIN 201034336
Plan administrator’s name BRIGHAM ANESTHESIA SOUTH, LLC
Plan administrator’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62901
Administrator’s telephone number 6184575111

Signature of
Role Plan administrator
Date 2012-04-04
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-04-04
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2010 201034336 2011-04-08 BRIGHAM ANESTHESIA SOUTH, LLC 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62901

Plan administrator’s name and address
Administrator’s EIN 201034336
Plan administrator’s name BRIGHAM ANESTHESIA SOUTH, LLC
Plan administrator’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62901
Administrator’s telephone number 6184575111

Signature of
Role Plan administrator
Date 2011-04-08
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-04-08
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
BRIGHAM ANESTHESIA SOUTH, LLC PROFIT SHARING PLAN 2009 201034336 2010-07-28 BRIGHAM ANESTHESIA SOUTH, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 6184575111
Plan sponsor’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62901

Plan administrator’s name and address
Administrator’s EIN 201034336
Plan administrator’s name BRIGHAM ANESTHESIA SOUTH, LLC
Plan administrator’s address 35 ALBANY ROAD, SUITE C, CARBONDALE, IL, 62901
Administrator’s telephone number 6184575111

Signature of
Role Plan administrator
Date 2010-07-28
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-28
Name of individual signing GARDNER KENNY
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JOHN S. BREWSTER, 111 W MAIN ST, POBOX 700, MARION, 62959, WILLIAMSON Agent 2004-03-31

Manager

Name and Address Role Appointment Date
KENNY M.D., GARDNER T., 35 ALBANY RD, STE C, CARBONDALE, IL, 62901 Manager 2022-02-28

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
LIMITED LIABILITY CO 248000082 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2011-05-09 2017-04-06 2018-01-01

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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