| Entity Name: | CHICAGO NEUROSPINE SURGERY PLLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Goodstanding |
| Date Formed: | 20 Sep 2021 |
| Company Number: | LLC_10880327 |
| File Number: | 10880327 |
| Type of Management: | Manager Managed |
| Date Status Change: | 23 Aug 2024 |
| Address | 19110 DARVIN DR. STE C, MOKENA, 60448, IL |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHICAGO NEUROSPINE SURGERY, PLLC 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 872731622 | 2024-05-01 | CHICAGO NEUROSPINE SURGERY, PLLC | 5 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-04-30 |
| Name of individual signing | SEAN SALEHI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-04-30 |
| Name of individual signing | SEAN SALEHI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7087653999 |
| Plan sponsor’s address | 19110 DARVIN DRIVE, SUITE C, MOKENA, IL, 60448 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-21 |
| Name of individual signing | SEAN SALEHI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-09-21 |
| Name of individual signing | SEAN SALEHI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| RITA W. GARRY, 200 S MICHIGAN AVE STE 1100, CHICAGO, 60604 | Agent | 2022-11-02 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| SEAN SALEHI, M.D., 19110 DARVIN DR., STE. C, MOKENA, IL, 60448 | Manager | 2024-08-23 |
Date of last update: 23 Dec 2024
