0001384233-15-000002.txt : 20150826 0001384233-15-000002.hdr.sgml : 20150826 20150826164924 ACCESSION NUMBER: 0001384233-15-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150826 DATE AS OF CHANGE: 20150826 EFFECTIVENESS DATE: 20150826 FILER: COMPANY DATA: COMPANY CONFORMED NAME: West Lakes Surgery Center, L.L.C. CENTRAL INDEX KEY: 0001384233 IRS NUMBER: 205345295 STATE OF INCORPORATION: IA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-246499 FILM NUMBER: 151076406 BUSINESS ADDRESS: STREET 1: 12499 UNIVERSITY AVENUE STREET 2: SUITE 100 CITY: CLIVE STATE: IA ZIP: 50325 BUSINESS PHONE: (515) 974-5050 MAIL ADDRESS: STREET 1: 12499 UNIVERSITY AVENUE STREET 2: SUITE 100 CITY: CLIVE STATE: IA ZIP: 50325 FORMER COMPANY: FORMER CONFORMED NAME: West Lakes Surgery Center L L C DATE OF NAME CHANGE: 20061220 D 1 primary_doc.xml X0707 D LIVE 0001384233 West Lakes Surgery Center, L.L.C. 12499 UNIVERSITY AVENUE SUITE 100 CLIVE IA IOWA 50325 (515) 974-5050 IOWA West Lakes Surgery Center L L C Limited Liability Company true William Jacobson, MD 12499 University Avenue Suite 100 Clive IA IOWA 50325 Executive Officer Director Manager and Chairperson Teri Formanek, MD 12499 University Avenue Suite 100 Clive IA IOWA 50325 Executive Officer Director Manager and Vice-Chairperson Mike Wegner 12499 University Avenue Suite 100 Clive IA IOWA 50325 Executive Officer Director Manager and Secretary / Treasurer Tim Simplot, MD 12499 University Avenue Suite 100 Clive IA IOWA 50325 Director Manager David Lind, MD 12499 University Avenue Suite 100 Clive IA IOWA 50325 Director Manager Kathy Goetz 12499 University Avenue Suite 100 Clive IA IOWA 50325 Director Manager Dennis Dornbier, MD 12499 University Avenue Suite 100 Clive IA IOWA 50325 Director Manager Dale Andres, MD 12499 University Avenue Suite 100 Clive IA IOWA 50325 Director Manager Other Health Care $5,000,001 - $25,000,000 06b false 2015-08-18 false true false 0 653951 653951 0 false 3 0 0 0 false West Lakes Surgery Center, L.L.C. Rob McCarville Rob McCarville Administrator 2015-08-26