0001733901-18-000001.txt : 20180313 0001733901-18-000001.hdr.sgml : 20180313 20180313122743 ACCESSION NUMBER: 0001733901-18-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180313 DATE AS OF CHANGE: 20180313 EFFECTIVENESS DATE: 20180313 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ProviderCo, LLC CENTRAL INDEX KEY: 0001733901 IRS NUMBER: 301031844 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-307562 FILM NUMBER: 18685780 BUSINESS ADDRESS: STREET 1: 3085 ADLAI STEVENSON DR. STREET 2: #203 CITY: SPRINGFIELD STATE: IL ZIP: 62703 BUSINESS PHONE: (217) 585-1600 MAIL ADDRESS: STREET 1: 3085 ADLAI STEVENSON DR. STREET 2: #203 CITY: SPRINGFIELD STATE: IL ZIP: 62703 D 1 primary_doc.xml X0708 D LIVE 0001733901 ProviderCo, LLC 3085 ADLAI STEVENSON DR. #203 SPRINGFIELD IL ILLINOIS 62703 (217) 585-1600 ILLINOIS None None Limited Liability Company true 2017 Bill Nelson 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Georgianne Broughton 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Ed Stellon 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Joel Johnson 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Mark Furlong 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Mark Stutrud 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Orville Mercer 3085 Adlia Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Patrick Phelan 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Shea Haury 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Manager of Issuer Marvin Lindsey 3085 Adlai Stevenson Drive #203 Springfield IL ILLINOIS 62703 Director Executive Director Other Health Care Decline to Disclose 06b false 2018-02-01 false true Limited Liability Company Interests true 40000 4000000 1040000 2960000 true 5 26 0 0 0 false ProviderCo, LLC /s/ Marvin Lindsey Marvin Lindsey Executive Director 2018-03-13