WEST SUBURBAN UROLOGY, S.C. EMPLOYEES' 401(K) PROFIT SHARING PLAN
|
2011
|
363004825
|
2012-10-13
|
WEST SUBURBAN UROLOGY, S.C.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1979-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309601498
|
Plan sponsor’s
address |
3825 HIGHLAND, PROF BLD II, STE 207, DOWNERS GROVE, IL, 60515
|
Plan administrator’s name and address
Administrator’s EIN |
363004825 |
Plan administrator’s name |
WEST SUBURBAN UROLOGY, S.C. |
Plan administrator’s
address |
3825 HIGHLAND, PROF BLD II, STE 207, DOWNERS GROVE, IL, 60515 |
Administrator’s telephone number |
6309601498 |
Signature of
Role |
Plan administrator |
Date |
2012-10-12 |
Name of individual signing |
PAUL J. WEST, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST SUBURBAN UROLOGY, S.C. EMPLOYEES' 401(K) PROFIT SHARING PLAN
|
2010
|
363004825
|
2011-10-17
|
WEST SUBURBAN UROLOGY, S.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1979-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309601498
|
Plan sponsor’s
address |
3825 HIGHLAND, PROF BLD II, STE 207, DOWNERS GROVE, IL, 60515
|
Plan administrator’s name and address
Administrator’s EIN |
363004825 |
Plan administrator’s name |
WEST SUBURBAN UROLOGY, S.C. |
Plan administrator’s
address |
3825 HIGHLAND, PROF BLD II, STE 207, DOWNERS GROVE, IL, 60515 |
Administrator’s telephone number |
6309601498 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
PAUL J. WEST, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WEST SUBURBAN UROLOGY, S.C. EMPLOYEES' 401(K) PROFIT SHARING PLAN
|
2009
|
363004825
|
2010-10-05
|
WEST SUBURBAN UROLOGY, S.C.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1979-03-01
|
Business code |
621111
|
Sponsor’s telephone number |
6309601498
|
Plan sponsor’s
address |
3825 HIGHLAND, PROF BLD II, STE 207, DOWNERS GROVE, IL, 60515
|
Plan administrator’s name and address
Administrator’s EIN |
363004825 |
Plan administrator’s name |
WEST SUBURBAN UROLOGY, S.C. |
Plan administrator’s
address |
3825 HIGHLAND, PROF BLD II, STE 207, DOWNERS GROVE, IL, 60515 |
Administrator’s telephone number |
6309601498 |
Signature of
Role |
Plan administrator |
Date |
2010-10-05 |
Name of individual signing |
PAUL J. WEST, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|