0001674402-19-000001.txt : 20190423 0001674402-19-000001.hdr.sgml : 20190423 20190423155621 ACCESSION NUMBER: 0001674402-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190423 DATE AS OF CHANGE: 20190423 EFFECTIVENESS DATE: 20190423 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: 021-337927 FILM NUMBER: 19761562 BUSINESS ADDRESS: STREET 1: 1221 N. DEARBORN STREET STREET 2: APT. 612 S. CITY: CHICAGO STATE: IL ZIP: 60610 BUSINESS PHONE: (626) 372-4884 MAIL ADDRESS: STREET 1: 1221 N. DEARBORN STREET STREET 2: APT. 612 S. CITY: CHICAGO STATE: IL ZIP: 60610 D 1 primary_doc.xml X0708 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. 6957 Kenneth Avenue Lincolnwood IL ILLINOIS 60712 Director Todd Cruikshank 770 W. Gladys Avenue Apt. 304 Chicago IL ILLINOIS 60661 Executive Officer Other Health Care Decline to Disclose 06b false 2019-04-10 false true true true false 0 4000000 1301760 2698240 false 15 0 0 0 true false Surgical Innovation Associates Inc. /s/ Alexei Mlodinow Alexei Mlodinow Director and President 2019-04-23