| Entity Name: | COBDEN REHABILITATION AND NURSING CENTER, LLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Goodstanding |
| Date Formed: | 10 May 2010 |
| Company Number: | LLC_02976234 |
| File Number: | 02976234 |
| Type of Management: | Manager Managed |
| Date Status Change: | 26 Apr 2024 |
| Address | 4213 MAIN ST, SKOKIE, 60076, IL |
| Place of Formation: | ILLINOIS |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| GCYBYPTLMF51 | 2024-12-05 | 430 S FRONT ST, COBDEN, IL, 62920, 2415, USA | 4213 MAIN STREET, SKOKIE, IL, 60076, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Division Name | COBDEN REHABILITATION AND NURSING CENTER, LLC |
| Congressional District | 12 |
| State/Country of Incorporation | IL, USA |
| Activation Date | 2023-12-08 |
| Initial Registration Date | 2004-04-16 |
| Entity Start Date | 2010-06-01 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 623110 |
| Product and Service Codes | Q401, Q506, Q701, Q999 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | ALAN IRNI |
| Address | 4213 MAIN STREET, SKOKIE, IL, 62920, 2415, USA |
| Title | ALTERNATE POC |
| Name | ALAN IRNI |
| Role | CFO |
| Address | 430 SOUTH FRONT STREET, COBDEN, IL, 62920, 2415, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | STEVEN BLISKO |
| Address | 430 SOUTH FRONT STREET, COBDEN, IL, 62920, 2415, USA |
| Title | ALTERNATE POC |
| Name | STEVEN BLISKO |
| Address | 430 SOUTH FRONT STREET, COBDEN, IL, 62920, 2415, USA |
| Past Performance | |
|---|---|
| Title | PRIMARY POC |
| Name | ALAN IRNI |
| Role | CFO |
| Address | 430 SOUTH FRONT STREET, COBDEN, IL, 62920, 2415, USA |
| Title | ALTERNATE POC |
| Name | ALAN IRNI |
| Role | CFO |
| Address | 430 SOUTH FRONT STREET, COBDEN, IL, 62920, 2415, USA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDIX SYSTEMS CONSULTANTS INC 401(K) PLAN | 2012 | 363666578 | 2013-08-08 | MEDIX SYSTEMS CONSULTANTS INC | 17 | |||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-08-08 |
| Name of individual signing | EDWIN UKPABY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1998-01-01 |
| Sponsor’s telephone number | 7083311271 |
| Plan sponsor’s address | 236 E 161ST STREET, SOUTH HOLLAND, IL, 60473 |
Plan administrator’s name and address
| Administrator’s EIN | 363666578 |
| Plan administrator’s name | MEDIX SYSTEMS CONSULTANTS INC |
| Plan administrator’s address | 236 E 161ST STREET, SOUTH HOLLAND, IL, 60473 |
| Administrator’s telephone number | 7083311271 |
Signature of
| Role | Plan administrator |
| Date | 2013-08-08 |
| Name of individual signing | EDWIN UKPABY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1998-01-01 |
| Sponsor’s telephone number | 7083311271 |
| Plan sponsor’s address | 236 E 161ST STREET, SOUTH HOLLAND, IL, 60473 |
Plan administrator’s name and address
| Administrator’s EIN | 363666578 |
| Plan administrator’s name | MEDIX SYSTEMS CONSULTANTS INC |
| Plan administrator’s address | 236 E 161ST STREET, SOUTH HOLLAND, IL, 60473 |
| Administrator’s telephone number | 7083311271 |
Signature of
| Role | Plan administrator |
| Date | 2013-08-08 |
| Name of individual signing | EDWIN UKPABY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| BUSINESS FILINGS INCORPORATED, 600 S 2ND ST STE 104, SPRINGFIELD, 62704 | Agent | 2020-01-30 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| STEVEN BLISKO, 4213 MAIN STREET, SKOKIE, IL, 60076 | Manager | 2024-04-26 |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| INTEGRITY HEALTHCARE OF COBDEN | Assumed name | 2016-02-29 | No data | No data | 2020-05-31 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | 36C25524K0165 | 2023-10-01 | 2024-09-30 | 2024-09-30 | |||||||||||||||||||||||||
|
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| Obligated Amount | 53427.60 |
| Current Award Amount | 53427.60 |
| Potential Award Amount | 53427.60 |
Description
| Title | FY24 3RD QUARTER EXPRESS REPORT DATES: 01/01/2024-03/31/2024 |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | COBDEN REHABILITATION AND NURSING CENTER, LLC |
| UEI | GCYBYPTLMF51 |
| Recipient Address | UNITED STATES, 430 S FRONT ST, COBDEN, UNION, ILLINOIS, 629202415 |
| Unique Award Key | CONT_IDV_36C25521D0012_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 661107.45 |
Description
| Title | EXERCISE OPTION YEAR 4 AND CONDUCT EPA. |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | COBDEN REHABILITATION AND NURSING CENTER, LLC |
| UEI | GCYBYPTLMF51 |
| Recipient Address | UNITED STATES, 430 S FRONT ST, COBDEN, UNION, ILLINOIS, 629202415 |
Date of last update: 13 Jan 2025
