SUBURBAN LUNG ASSOCIATES, S. C. DEFINED BENEFIT PLAN
|
2012
|
363378337
|
2013-07-19
|
SUBURBAN LUNG ASSOCIATES, S. C.
|
44
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S.C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2013-07-19 |
Name of individual signing |
EDWARD J. DIAMOND. M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-19 |
Name of individual signing |
EDWARD J. DIAMOND, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S. C. 401(K) PLAN
|
2012
|
363378337
|
2013-07-12
|
SUBURBAN LUNG ASSOCIATES, S. C.
|
93
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1985-09-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Signature of
Role |
Plan administrator |
Date |
2013-07-12 |
Name of individual signing |
EDWARD J. DIAMOND, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-12 |
Name of individual signing |
EDWARD J. DIAMOND, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S. C. DEFINED BENEFIT PLAN
|
2011
|
363378337
|
2012-10-01
|
SUBURBAN LUNG ASSOCIATES, S. C.
|
47
|
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S.C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2012-10-01 |
Name of individual signing |
EDWARD J. DIAMOND. M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-01 |
Name of individual signing |
EDWARD J. DIAMOND, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S. C. 401(K) PLAN
|
2011
|
363378337
|
2012-10-11
|
SUBURBAN LUNG ASSOCIATES, S. C.
|
82
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1985-09-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S. C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
EDWARD J. DIAMOND, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-11 |
Name of individual signing |
EDWARD J. DIAMOND, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S. C. DEFINED BENEFIT PLAN
|
2011
|
363378337
|
2012-10-08
|
SUBURBAN LUNG ASSOCIATES, S. C.
|
47
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S.C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2012-10-08 |
Name of individual signing |
EDWARD J. DIAMOND. M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-08 |
Name of individual signing |
EDWARD J. DIAMOND, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S. C. DEFINED BENEFIT PLAN
|
2011
|
363378337
|
2012-10-08
|
SUBURBAN LUNG ASSOCIATES, S. C.
|
47
|
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S.C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2012-10-08 |
Name of individual signing |
EDWARD J. DIAMOND. M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-08 |
Name of individual signing |
EDWARD J. DIAMOND, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S.C. 401(K) PLAN
|
2010
|
363378337
|
2011-09-30
|
SUBURBAN LUNG ASSOCIATES, S.C.
|
74
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1985-09-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S.C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2011-09-30 |
Name of individual signing |
LARRY BUTCHER PREPARER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S.C. DEFINED BENEFIT PLAN
|
2010
|
363378337
|
2011-06-29
|
SUBURBAN LUNG ASSOCIATES, S.C.
|
40
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S.C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2011-06-29 |
Name of individual signing |
LARRY BUTCHER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S.C. DEFINED BENEFIT PLAN
|
2009
|
363378337
|
2010-08-17
|
SUBURBAN LUNG ASSOCIATES, S.C.
|
38
|
|
File |
View Page
|
Three-digit plan number (PN) |
004
|
Effective date of plan |
2002-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S.C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2010-08-17 |
Name of individual signing |
LARRY BUTCHER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUBURBAN LUNG ASSOCIATES, S.C. 401(K) PLAN
|
2009
|
363378337
|
2010-08-17
|
SUBURBAN LUNG ASSOCIATES, S.C.
|
79
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1985-09-01
|
Business code |
621111
|
Sponsor’s telephone number |
8479813660
|
Plan sponsor’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007
|
Plan administrator’s name and address
Administrator’s EIN |
363378337 |
Plan administrator’s name |
SUBURBAN LUNG ASSOCIATES, S.C. |
Plan administrator’s
address |
800 BIESTERFIELD ROAD, SUITE 510, ELK GROVE VILLAGE, IL, 60007 |
Administrator’s telephone number |
8479813660 |
Signature of
Role |
Plan administrator |
Date |
2010-08-17 |
Name of individual signing |
LARRY BUTCHER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|