| Entity Name: | BELOIT HEALTH SYSTEM, INC. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Not-for-Profit |
| Status: | Goodstanding |
| Date Formed: | 30 Oct 1991 |
| Company Number: | CORP_56587411 |
| File Number: | 56587411 |
| Type of Business: | Charitable or benevolent |
| Place of Formation: | WISCONSIN |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMCHECK MIDWEST 401K PLAN | 2013 | 391420944 | 2014-05-07 | BELOIT REGIONAL HOSPICE | 51 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 680632605 |
| Plan administrator’s name | AMCHECK MIDWEST DBA TWO AND A HALF FALCONS |
| Plan administrator’s address | 1475 E WOODFIELD ROAD SUITE 108, SCHAUMBERG, IL, 60173 |
| Administrator’s telephone number | 8473976100 |
Signature of
| Role | Plan administrator |
| Date | 2014-05-07 |
| Name of individual signing | JOHN BAWDEN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 6083637421 |
| Plan sponsor’s address | 1475 E WOODFIELD ROAD SUITE 108, SCHAUMBERG, IL, 60173 |
Plan administrator’s name and address
| Administrator’s EIN | 680632605 |
| Plan administrator’s name | AMCHECK MIDWEST DBA TWO AND A HALF FALCONS |
| Plan administrator’s address | 1475 E WOODFIELD ROAD SUITE 108, SCHAUMBERG, IL, 60173 |
| Administrator’s telephone number | 8473976100 |
Signature of
| Role | Plan administrator |
| Date | 2014-04-08 |
| Name of individual signing | JOHN BAWDEN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| RODNEY W. KIMES, 419 MAIN ST, PECATONICA, 61063, WINNEBAGO | Agent | 2024-06-04 |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| PHARMACY | 054020281 | No data | No data | LICENSED PHARMACY | No data | 2017-06-08 | 2024-01-06 | 2026-03-31 |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| NORTHPOINTE SURGERY CENTER | NFP Assume Name | 2024-04-26 | No data | No data | No data |
| BELOIT REGIONAL HOSPICE | NFP Assume Name | 2023-02-03 | No data | No data | No data |
| NORTHPOINTE HEALTH AND WELLNESS | NFP Assume Name | 2017-03-08 | No data | No data | No data |
| Name | Change Date |
|---|---|
| BELOIT MEMORIAL HOSPITAL, INCORPORATED | 2010-09-27 |
| BELOIT MEMORIAL HOSPITAL, INC. | 2010-09-27 |
Date of last update: 23 Dec 2024
