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  5. MEDINA NURSING CENTER, INC.

MEDINA NURSING CENTER, INC.

Company Details

Entity Name: MEDINA NURSING CENTER, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 21 Oct 1976
Company Number: CORP_51011201
File Number: 51011201
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
GKDXDC4EEGP3 2025-02-20 402 S CENTER ST, DURAND, IL, 61024, 9590, USA 402 S CENTER ST, DURAND, IL, 61024, 9590, USA

Business Information
Congressional District 16
State/Country of Incorporation IL, USA
Activation Date 2024-02-26
Initial Registration Date 2012-05-24
Entity Start Date 1965-05-17
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 623110
Product and Service Codes Q402

Points of Contacts
Electronic Business
Title PRIMARY POC
Name PEGGY LAUER
Role ADMINISTRATOR
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Title ALTERNATE POC
Name DAWN JOHNSON
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Government Business
Title PRIMARY POC
Name PEGGY LAUER
Role ADMINTRATOR
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Title ALTERNATE POC
Name LORI HIGGS
Role FINANCIAL CONTROLLER
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Past Performance
Title PRIMARY POC
Name PEGGY LAUER
Address 402 S CENTER, DURAND, IL, 61024, 9590, USA
Title ALTERNATE POC
Name LORI HIGGS
Role FINANCIAL CONTROLLER
Address 402 S CENTER, DURAND, IL, 61024, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2023 362887017 2024-06-03 MEDINA NURSING CENTER, INC. 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2024-06-03
Name of individual signing PEGGY LAUER
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2022 362887017 2023-09-07 MEDINA NURSING CENTER, INC. 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2023-09-07
Name of individual signing PEGGY LAUER
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2021 362887017 2022-03-14 MEDINA NURSING CENTER, INC. 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2020 362887017 2021-06-02 MEDINA NURSING CENTER, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2019 362887017 2020-07-08 MEDINA NURSING CENTER, INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2018 362887017 2019-07-10 MEDINA NURSING CENTER, INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2019-07-10
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-10
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2017 362887017 2018-05-03 MEDINA NURSING CENTER, INC. 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2018-05-03
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-03
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2016 362887017 2017-06-07 MEDINA NURSING CENTER, INC. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-07
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2015 362887017 2016-06-20 MEDINA NURSING CENTER, INC. 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2016-06-20
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-20
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
MEDINA MANOR'S 401(K) RETIREMENT PLAN 2014 362887017 2015-05-08 MEDINA NURSING CENTER, INC. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 623000
Sponsor’s telephone number 8152482151
Plan sponsor’s address 402 SOUTH CENTER STREET, DURAND, IL, 61024

Signature of
Role Plan administrator
Date 2015-05-08
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-08
Name of individual signing HOLGEIR OKSNEVAD
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
HOLGEIR J OKSNEVAD, 402 SOUTH CENTER ST, DURAND, 61024, WINNEBAGO Agent 2010-11-24

President

Name and Address Role
HOLGEIR J OSKNEVAD, 1405 OTTERCREEK DR DURAND 61024 President

Secretary

Name and Address Role
HOLGEIR J OKSNEVAD Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
MEDINA NURSING & REHAB Assume Name 2020-08-31 No data No data No data
CNA FIRST BY MEDINA No data 2010-06-29 2012-10-09 Voluntary Cancellation No data
THERAPY FIRST BY MEDINA Assume Name 2010-06-29 No data No data No data
CNA FIRST No data 2009-06-22 2010-06-29 Voluntary Cancellation No data
MEDINA MANOR Assume Name 2005-11-16 No data No data No data

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 100000 1000000 1

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State

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