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DERICK DERMATOLOGY PLLC

Headquarter

Company Details

Entity Name: DERICK DERMATOLOGY PLLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 03 Mar 2006
Company Number: LLC_01784005
File Number: 01784005
Type of Management: Member Managed
Date Status Change: 18 Feb 2024
Address 1531 S GROVE AVE, BARRINGTON, 60010, IL
Place of Formation: ILLINOIS

Links between entities

Type Company Name Company Number State
Headquarter of DERICK DERMATOLOGY PLLC, FLORIDA M21000017579 FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST 2023 204569672 2024-06-26 DERICK DERMATOLOGY, PLLC 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2024-06-26
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-06-26
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST 2022 204569672 2023-10-04 DERICK DERMATOLOGY, PLLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2023-10-04
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-04
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST 2021 204569672 2022-09-30 DERICK DERMATOLOGY, PLLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2022-09-30
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-30
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST 2020 204569672 2021-07-19 DERICK DERMATOLOGY, LLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2021-07-19
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-19
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST 2019 204569672 2020-08-03 DERICK DERMATOLOGY, LLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123

Signature of

Role Plan administrator
Date 2020-08-03
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-03
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST 2018 204569672 2019-08-12 DERICK DERMATOLOGY, LLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1531 SOUTH GROVE AVENUE, SUITE 101, BARRINGTON, IL, 60010

Signature of

Role Plan administrator
Date 2019-08-10
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-10
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY LLC 401(K) PLAN 2017 204569672 2018-05-30 DERICK DERMATOLOGY LLC 91
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-02-01
Business code 621111
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1531 S GROVE AVE SUITE 101, BARRINGTON, IL, 60010

Signature of

Role Plan administrator
Date 2018-05-30
Name of individual signing KAELYN TERRY
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST 2017 204569672 2018-10-01 DERICK DERMATOLOGY, LLC 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1531 SOUTH GROVE AVENUE, SUITE 101, BARRINGTON, IL, 60010

Signature of

Role Plan administrator
Date 2018-09-27
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-27
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY LLC 401(K) PLAN 2016 204569672 2017-07-06 DERICK DERMATOLOGY LLC 111
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-02-01
Business code 621111
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1531 S GROVE AVE SUITE 101, BARRINGTON, IL, 60010

Signature of

Role Plan administrator
Date 2017-07-06
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST 2016 204569672 2017-09-25 DERICK DERMATOLOGY, LLC 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 541990
Sponsor’s telephone number 8473818899
Plan sponsor’s address 1531 SOUTH GROVE AVENUE, SUITE 101, SUITE 101, BARRINGTON, IL, 60010

Signature of

Role Plan administrator
Date 2017-09-25
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-25
Name of individual signing MICHAEL DERICK
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
AMY J DERICK, 1531 S GROVE AVE, BARRINGTON, 60010 Agent 2017-03-10

Manager

Name and Address Role Appointment Date
DERICK, AMY J M.D., 1531 S GROVE AVE STE 101, BARRINGTON, IL, 60010 Manager 2024-02-18

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
LIMITED LIABILITY CO 248005014 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248005020 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248005019 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248005018 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248005017 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248005012 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248005013 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248005016 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248005015 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2024-06-30 2024-06-30 2025-01-01
LIMITED LIABILITY CO 248002622 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2019-06-10 2021-10-29 2025-01-01

Historical Names

Name Change Date
DERICK DERMATOLOGY LLC 2021-07-13

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State