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  5. ANESTHESIA PAIN SERVICES, LLC

ANESTHESIA PAIN SERVICES, LLC

Company Details

Entity Name: ANESTHESIA PAIN SERVICES, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 23 Feb 2007
Company Number: LLC_02118793
File Number: 02118793
Type of Management: Manager Managed
Date Status Change: 31 Jan 2024
Address 825 BUCCANEER CT, DECATUR, 62521, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANESTHESIA PAIN SERVICES, LLC CASH BALANCE PLAN 2023 352297264 2024-10-02 ANESTHESIA PAIN SERVICES, LLC 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2174642729
Plan sponsor’s address 1800 E. LAKE SHORE DR., DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2024-10-01
Name of individual signing STACEY FLETCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-01
Name of individual signing STACEY FLETCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES, LLC CASH BALANCE PLAN 2022 352297264 2023-09-29 ANESTHESIA PAIN SERVICES, LLC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2174642729
Plan sponsor’s address 1800 E. LAKE SHORE DR., DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2023-09-29
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-29
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES, LLC CASH BALANCE PLAN 2021 352297264 2022-08-22 ANESTHESIA PAIN SERVICES, LLC 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2174642729
Plan sponsor’s address 1800 E. LAKE SHORE DR., DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2022-08-22
Name of individual signing STACEY FLETCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-08-22
Name of individual signing STACEY FLETCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES, LLC CASH BALANCE PLAN 2020 352297264 2021-07-08 ANESTHESIA PAIN SERVICES, LLC 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2174642729
Plan sponsor’s address 1800 E. LAKE SHORE DR., DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2021-07-07
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-07
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES, LLC CASH BALANCE PLAN 2019 352297264 2020-09-24 ANESTHESIA PAIN SERVICES, LLC 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2174642729
Plan sponsor’s address 1800 E. LAKE SHORE DR., DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2020-09-24
Name of individual signing STACEY FLETCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-24
Name of individual signing STACEY FLETCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES, LLC CASH BALANCE PLAN 2018 352297264 2019-09-19 ANESTHESIA PAIN SERVICES, LLC 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2174642729
Plan sponsor’s address 4160 S. LAKE COURT, DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2019-09-19
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-19
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES, LLC CASH BALANCE PLAN 2017 352297264 2018-10-03 ANESTHESIA PAIN SERVICES, LLC 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2174642729
Plan sponsor’s address 4160 S. LAKE COURT, DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2018-10-03
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-03
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES 401(K) PLAN 2016 352297264 2017-08-23 ANESTHESIA PAIN SERVICES LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621399
Sponsor’s telephone number 2174645839
Plan sponsor’s address 1800 E. LAKE SHORE DRIVE, DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2017-08-23
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-23
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES 401(K) PLAN 2016 352297264 2017-06-15 ANESTHESIA PAIN SERVICES LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621399
Sponsor’s telephone number 2174645839
Plan sponsor’s address 1800 E. LAKE SHORE DRIVE, DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2017-06-15
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-15
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
ANESTHESIA PAIN SERVICES, LLC CASH BALANCE PLAN 2016 352297264 2017-07-14 ANESTHESIA PAIN SERVICES, LLC 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2174642729
Plan sponsor’s address 4160 S. LAKE COURT, DECATUR, IL, 62521

Signature of
Role Plan administrator
Date 2017-07-14
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-14
Name of individual signing SHANE FANCHER
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SHANE R FANCHER, 1800 E LAKE SHORE DR, DECATUR, 62521, MACON Agent 2012-03-06

Manager

Name and Address Role Appointment Date
FANCHER M.D., SHANE, 825 BUCCANEER CT, DECATUR, IL, 62521 Manager 2007-02-23
JOHN M. FURRY, M.D., 1800 E. LAKE SHOR DR., DECATUR, IL, 62521 Manager 2022-10-19

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
LIMITED LIABILITY CO 248000972 No data No data PROFESSIONAL LIMITED LIABILITY COMPANY No data 2014-03-12 2021-10-29 2025-01-01

Historical Names

Name Change Date
AEF MANAGEMENT, LLC 2007-10-15

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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