| Entity Name: | INDUSTRIAL & SPORT REHABILITATION, LTD. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Merged/Consolidated |
| Date Formed: | 24 Oct 1995 |
| Company Number: | CORP_58564656 |
| File Number: | 58564656 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Date Status Change: | 02 Sep 2003 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASSOCIATED PHYSICIANS GROUP MEDOVA LIFESTYLE HEALTH PLAN | 2022 | 900068033 | 2024-08-28 | ASSOCIATED PHYSICIANS GROUP | 0 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 200200514 |
| Plan administrator’s name | RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s address | 510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number | 6153700051 |
Signature of
| Role | Plan administrator |
| Date | 2024-08-28 |
| Name of individual signing | ROBERT MOORE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2021-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 6186288211 |
| Plan sponsor’s address | 916 TALON DR, O FALLON, IL, 622691848 |
Plan administrator’s name and address
| Administrator’s EIN | 200200514 |
| Plan administrator’s name | RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s address | 510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number | 6153700051 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-29 |
| Name of individual signing | ROBERT MOORE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| LARRY B VICK, 102A N STATE STREET, FREEBURG, 62243, ST. CLAIR | Agent | 1999-04-13 |
| Name and Address | Role |
|---|---|
| LARRY B VICK, 3122 SAVE RD BELLEVILLE 62221 | President |
| Name | Type | Effective Date | Cancellation Date | Cancellation Type | Last Renewal Date |
|---|---|---|---|---|---|
| MIDWEST COMMUNITY OUTREACH | No data | 1999-06-02 | 2001-03-29 | Expired | No data |
| ASSOCIATED PHYSICIANS GROUP | No data | 1997-11-14 | 2003-04-11 | Voluntary Cancellation | No data |
| Name | Change Date |
|---|---|
| VICK CHIROPRACTIC CLINIC, LTD. | 1995-11-02 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 30000 | 200000 | 1 |
Date of last update: 23 Dec 2024
