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  5. STAUNTON CLINIC, LLC

STAUNTON CLINIC, LLC

Company Details

Entity Name: STAUNTON CLINIC, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 14 Mar 2005
Company Number: LLC_01451782
File Number: 01451782
Type of Management: Member Managed
Date Status Change: 13 Feb 2024
Expiration Date: 01 Mar 2055
Address 444 NORTH EDWARDSVILLE STREET, STAUNTON, 62088, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2023 202573179 2024-06-19 STAUNTON CLINIC LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2024-06-18
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-06-18
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2022 202573179 2023-06-09 STAUNTON CLINIC LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2023-06-08
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2021 202573179 2022-06-21 STAUNTON CLINIC LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2022-06-21
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2020 202573179 2021-06-25 STAUNTON CLINIC LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2021-06-24
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-24
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2019 202573179 2020-07-17 STAUNTON CLINIC LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2020-07-17
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2018 202573179 2019-05-30 STAUNTON CLINIC LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2019-05-30
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-30
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2017 202573179 2018-06-21 STAUNTON CLINIC LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2018-06-21
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2016 202573179 2017-04-18 STAUNTON CLINIC LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2017-04-18
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2015 202573179 2016-05-03 STAUNTON CLINIC LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2016-05-03
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature
STAUNTON CLINIC LLC RETIREMENT SAVINGS PLAN 2014 202573179 2015-07-21 STAUNTON CLINIC LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6186353800
Plan sponsor’s address 444 N. EDWARDSVILLE ST., STAUNTON, IL, 62088

Signature of
Role Plan administrator
Date 2015-07-21
Name of individual signing BRYAN SIEGFRIED
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DIANE L. DOBRINO, 444 N. EDWARDSVILLE STREET, STAUNTON, 62088, MACOUPIN Agent 2008-06-03

Manager

Name and Address Role Appointment Date
JAIN, RAJNEESH, 5 EVERGREEN DR, STAUNTON, IL, 99999 Manager 2024-02-13
MATHUR, MANISH, 49 E SOUTHCREST CIRCLE, EDWARDSVILLE, IL, 99999 Manager 2024-02-13
SIEGFRIED, BRYAN, 1036 FALCON CREST CT, STAUNTON, IL, 99999 Manager 2024-02-13

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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