PAIN & SPINE INSTITUTE, LLC

Company Details

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

DAKOTA CONTRACTING, LLC RETIREMENT PLAN

2012

800579808

2013-06-26

DAKOTA CONTRACTING, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-04-15
Business code	812990
Sponsor’s telephone number	8475261500
Plan sponsor’s address	1345B NORTH OLD RAND RD, WAUCONDA, IL, 60084

Signature of

Role	Plan administrator
Date	2013-06-26
Name of individual signing	ADAM JURCZYK
Valid signature	Filed with authorized/valid electronic signature

DAKOTA CONTRACTING, LLC RETIREMENT PLAN

2011

800579808

2012-06-27

DAKOTA CONTRACTING, LLC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2011-04-15
Business code	812990
Sponsor’s telephone number	8475261500
Plan sponsor’s address	1345 B NORTH OLD RAND RD., WAUCONDA, IL, 60084

Plan administrator’s name and address

Administrator’s EIN	800579808
Plan administrator’s name	DAKOTA CONTRACTING, LLC
Plan administrator’s address	1345 B NORTH OLD RAND RD., WAUCONDA, IL, 60084
Administrator’s telephone number	8475261500

Signature of

Role	Plan administrator
Date	2012-06-27
Name of individual signing	ADAM JURCZYK
Valid signature	Filed with authorized/valid electronic signature

Name and Address	Role	Appointment Date
UDIT V. PATEL, 744 ESSINGTON RD., JOLIET, 60435	Agent	2019-08-14

Name and Address	Role	Appointment Date
SHARMA, SAMIR, 744 ESSINGTON ROAD, JOLIET, IL, 60435	Manager	2024-07-19
PATEL, UDIT V., 744 ESSINGTON ROAD, JOLIET, IL, 60435	Manager	2024-07-19

Name	Change Date
MIDWEST INSTITUTE FOR INTERVENTIONAL PAINE MEDICINE & SPINE CARE, LLC	2007-01-03

Date of last update: 16 Jan 2025