|
PALOS ANESTHESIA ASSOC, S.C. INDIVIDUAL ACCT. PLAN
|
2011
|
363358915
|
2013-05-09
|
PALOS ANESTHESIA ASSOCIATES, S.C.
|
15
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1985-09-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6308682200
|
| Plan sponsor’s
address |
40 SHUMAN BLVD STE 275, NAPERVILLE, IL, 60563
|
Plan administrator’s name and address
| Administrator’s EIN |
363358915 |
| Plan administrator’s name |
PALOS ANESTHESIA ASSOCIATES, S.C. |
| Plan administrator’s
address |
40 SHUMAN BLVD STE 275, NAPERVILLE, IL, 60563 |
| Administrator’s telephone number |
6308682200 |
Signature of
| Role |
Plan administrator |
| Date |
2013-05-09 |
| Name of individual signing |
STEPHEN L HENNENFENT MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALOS ANESTHESIA ASSOC SC INDIVIDUAL ACCT PLAN
|
2010
|
363358915
|
2012-05-31
|
PALOS ANESTHESIA ASSOCIATES, S C
|
15
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1985-09-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6308682200
|
| Plan sponsor’s
address |
40 SHUMAN BLVD STE 275, NAPERVILLE, IL, 60563
|
Plan administrator’s name and address
| Administrator’s EIN |
363358915 |
| Plan administrator’s name |
PALOS ANESTHESIA ASSOCIATES S C |
| Plan administrator’s
address |
40 SHUMAN BLVD STE 275, NAPERVILLE, IL, 60563 |
| Administrator’s telephone number |
6308682200 |
Signature of
| Role |
Plan administrator |
| Date |
2012-05-31 |
| Name of individual signing |
STEPHEN L HENNENFENT MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PALOS ANESTHESIA ASSOC SC INDIVIDUAL ACCT PLAN
|
2009
|
363358915
|
2011-06-02
|
PALOS ANESTHESIA ASSOCIATES, S C
|
16
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1985-09-01
|
| Business code |
621111
|
| Sponsor’s telephone number |
6308682200
|
| Plan sponsor’s
address |
40 SHUMAN BLVD STE 275, NAPERVILLE, IL, 60563
|
Plan administrator’s name and address
| Administrator’s EIN |
363358915 |
| Plan administrator’s name |
PALOS ANESTHESIA ASSOCIATES S C |
| Plan administrator’s
address |
40 SHUMAN BLVD STE 275, NAPERVILLE, IL, 60563 |
| Administrator’s telephone number |
6308682200 |
Signature of
| Role |
Plan administrator |
| Date |
2011-06-02 |
| Name of individual signing |
STEPHEN L HENNENFENT MD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
