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  5. AMBROSE MEDICAL, PLLC

AMBROSE MEDICAL, PLLC

Company Details

Entity Name: AMBROSE MEDICAL, PLLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 16 Apr 2014
Company Number: LLC_04681487
File Number: 04681487
Type of Management: Manager Managed
Date Status Change: 06 Mar 2024
Address 1811 STATE ROUTE 157 SUITE 1B, EDWARDSVILLE, 62025, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AMBROSE MEDICAL 401(K) PLAN 2023 465470460 2024-05-13 AMBROSE MEDICAL, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621900
Sponsor’s telephone number 3145606708
Plan sponsor’s address 1181 STATE ROUTE 157, SUITE 1B, EDWARDSVILLE, IL, 62025

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-13
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
AMBROSE MEDICAL 401(K) PLAN 2022 465470460 2023-05-27 AMBROSE MEDICAL, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621900
Sponsor’s telephone number 3145606708
Plan sponsor’s address 1181 STATE ROUTE 157, SUITE 1B, EDWARDSVILLE, IL, 62025

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-05-27
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
AMBROSE MEDICAL 401(K) PLAN 2021 465470460 2022-09-01 AMBROSE MEDICAL, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621900
Sponsor’s telephone number 3145606708
Plan sponsor’s address 1181 STATE ROUTE 157, SUITE 1B, EDWARDSVILLE, IL, 62025

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-09-01
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
PERFORMANCE MEDICAL CLINIC 401(K) PLAN 2020 465470460 2021-10-11 CENTER FOR ADVANCED MEDICINE, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621900
Sponsor’s telephone number 3145606708
Plan sponsor’s address 5036 N. ILLINOIS STREET, SUITE 1, FAIRVIEW HEIGHTS, IL, 62208

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-10-10
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
CENTER FOR ADVANCED MEDICINE, LLC 401(K) PLAN 2016 465470460 2017-05-22 CENTER FOR ADVANCED MEDICINE, LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621399
Sponsor’s telephone number 6186716800
Plan sponsor’s address 5036 N. ILLINOIS ST., SUITE 1, FAIRVIEW HEIGHTS, IL, 62208

Agent

Name and Address Role Appointment Date
MICHAEL AMBROSE, 1 GRAY CUB CT, GLEN CARBON, 62034 Agent 2018-02-05

Manager

Name and Address Role Appointment Date
AMBROSE, MICHAEL T, 1 GRAY CUB CT., GLEN CARBON, IL, 62034 Manager 2024-03-06

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
PERFORMANCE MEDICAL CLINIC Assumed name 2017-11-20 No data No data 2020-03-03

Historical Names

Name Change Date
CENTER FOR ADVANCED MEDICINE, LLC 2021-09-20
AMBROSE MEDICAL, LLC 2021-09-20
ADVANCED MEDICAL AND PAIN SOLUTIONS, LLC 2014-04-30

Related by officers

MICHAEL AMBROSE, 1 GRAY CUB CT, GLEN CARBON, 62034

PERFORMANCE HEALTHCARE SOLUTIONS LLC

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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