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MADISON STREET CLINIC, P.C.

MADISON STREET CLINIC, P.C.

Company Details

Entity Name:	MADISON STREET CLINIC, P.C.
Jurisdiction:	Illinois
Entity Type:	Corporation - Domestic BCA
Status:	Dissolved
Date Formed:	01 Aug 1973
Date of Dissolution:	10 Jan 2014
Company Number:	CORP_50287262
File Number:	50287262
Type of Business:	Incorporated under the Professional Service Corporation Act
Date Status Change:	10 Jan 2014
Place of Formation:	ILLINOIS

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

MADISON STREET CLINIC PROFIT SHARING PLAN

2012

370971369

2013-07-11

MADISON STREET CLINIC

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1974-06-30
Business code	621111
Sponsor’s telephone number	8158447513
Plan sponsor’s DBA name	MADISON STREET CLINC PC
Plan sponsor’s address	700 JOHN STREET, PONTIAC, IL, 61764

Signature of

Role	Plan administrator
Date	2013-07-11
Name of individual signing	ROBERT HEINS
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2013-07-11
Name of individual signing	ROBERT HEINS
Valid signature	Filed with authorized/valid electronic signature

Agent

Name and Address	Role	Appointment Date
DR ROBERT E HEINS, 520 W MADISON STREET, PONTIAC, 61764, LIVINGSTON	Agent	1987-08-06

President

Name and Address	Role
ROBERT E HEINS, 700 JOHN ST PONTIAC IL 61764	President

Shares

Class	Series	Voting Rights	Authorized Shares	Issued Shares	Par Value
COMM	No data	Voting Rights	10000	1000000	No data

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State