| Entity Name: | FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Not-for-Profit |
| Status: | Goodstanding |
| Date Formed: | 14 May 1943 |
| Company Number: | CORP_27570836 |
| File Number: | 27570836 |
| Place of Formation: | ILLINOIS |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GEXLNF79A683 | 2024-07-10 | 305 NW 11TH ST, FAIRFIELD, IL, 62837, 1203, USA | 303 NORTHWEST 11TH STREET, FAIRFIELD, IL, 62837, 1203, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| URL | http://www.fairfieldmemorial.org |
| Congressional District | 12 |
| State/Country of Incorporation | IL, USA |
| Activation Date | 2023-07-13 |
| Initial Registration Date | 2006-04-25 |
| Entity Start Date | 1943-05-14 |
| Fiscal Year End Close Date | Jun 30 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | MARY KNIGHT |
| Address | 303 NW 11TH STREET, FAIRFIELD, IL, 62837, USA |
| Title | ALTERNATE POC |
| Name | KRISTIN BOLDT |
| Role | INTERIM CFO/CONTROLLER |
| Address | 303 NW 11TH STREET, FAIRFIELD, IL, 62837, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | DANA TAYLOR |
| Role | INTERIM CEO/COO |
| Address | 303 NW 11TH STREET, FAIRFIELD, IL, 62837, USA |
| Past Performance | |
|---|---|
| Title | PRIMARY POC |
| Name | MARY KNIGHT |
| Address | 303 NW 11TH STREET, FAIRFIELD, IL, 62837, USA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FAIRFIELD MEMORIAL HOSPITAL BENEFIT PLAN | 2019 | 370661202 | 2020-10-14 | FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION | 260 | |||||||||||||||||||||||||||||
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| Active participants | 249 |
Signature of
| Role | Plan administrator |
| Date | 2020-10-14 |
| Name of individual signing | AMY MARSH |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| PATRICK L MOLT, 303 NW 11TH STREET, FAIRFIELD, 62837, WAYNE | Agent | 2015-05-06 |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| DETECTIVE BOARD | 120500175 | No data | No data | ARMED PROPRIETARY SECURITY FORCE | No data | 2023-08-10 | 2023-08-10 | 2026-08-31 |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| WAY-FAIR | No data | 1993-08-06 | 2015-10-01 | Involuntary Cancellation | No data |
Date of last update: 23 Dec 2024
