0001674402-16-000001.txt : 20160615 0001674402-16-000001.hdr.sgml : 20160615 20160615112703 ACCESSION NUMBER: 0001674402-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160615 DATE AS OF CHANGE: 20160615 EFFECTIVENESS DATE: 20160615 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Surgical Innovation Associates Inc. CENTRAL INDEX KEY: 0001674402 IRS NUMBER: 811963100 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-265070 FILM NUMBER: 161714690 BUSINESS ADDRESS: STREET 1: 1221 N. DEARBORN STREET STREET 2: APT. 6125 CITY: CHICAGO STATE: IL ZIP: 60610 BUSINESS PHONE: (626) 372-4884 MAIL ADDRESS: STREET 1: 1221 N. DEARBORN STREET STREET 2: APT. 6125 CITY: CHICAGO STATE: IL ZIP: 60610 D 1 primary_doc.xml X0707 D LIVE 0001674402 Surgical Innovation Associates Inc. 1221 N. DEARBORN STREET APT. 612 S. CHICAGO IL ILLINOIS 60610 (626) 372-4884 DELAWARE None None Corporation true 2016 Alexei Mlodinow 1221 N. Dearborn St. Apt. 612 S. Chicago IL ILLINOIS 60610 Executive Officer Director John Y.S. Kim, M.D. 1221 N. Dearborn St. Apt. 612 S. Chicago IL ILLINOIS 60610 Director Other Health Care Decline to Disclose 06b false 2016-05-06 false true true false 10000 1300000 80000 1220000 false 3 0 0 0 false Surgical Innovation Associates Inc. /s/ Alexei Mlodinow Alexei Mlodinow Director and President 2016-06-15