0000895527-22-000004.txt : 20220218 0000895527-22-000004.hdr.sgml : 20220218 20220218103707 ACCESSION NUMBER: 0000895527-22-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220218 DATE AS OF CHANGE: 20220218 EFFECTIVENESS DATE: 20220218 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Palos Surgicenter, LLC CENTRAL INDEX KEY: 0001890916 IRS NUMBER: 364404305 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-434165 FILM NUMBER: 22651254 BUSINESS ADDRESS: STREET 1: 7340 W. COLLEGE DRIVE STREET 2: #1 CITY: PALOS HEIGHTS STATE: IL ZIP: 60463 BUSINESS PHONE: 708-361-3233 MAIL ADDRESS: STREET 1: 7340 W. COLLEGE DRIVE STREET 2: #1 CITY: PALOS HEIGHTS STATE: IL ZIP: 60463 D 1 primary_doc.xml X0708 D LIVE 0001890916 Palos Surgicenter, LLC 7340 W. COLLEGE DRIVE #1 PALOS HEIGHTS IL ILLINOIS 60463 708-361-3233 ILLINOIS None None Limited Liability Company true Muhamad Amine 7340 W. College Drive #1 Palos Heights IL ILLINOIS 60463 Executive Officer Director Christopher Farley 7340 W. College Drive #1 Palos Heights IL ILLINOIS 60463 Director William Kosmala 7340 W. College Drive #1 Palos Heights IL ILLINOIS 60463 Director Nicholas Speziale 7340 W. College Drive #1 Palos Heights IL ILLINOIS 60463 Director Bob Ryan 7340 W. College Drive #1 Palos Heights IL ILLINOIS 60463 Director Amanda Nunkovich 7340 W. College Drive #1 Palos Heights IL ILLINOIS 60463 Executive Officer Other Health Care Decline to Disclose 06b false 2022-02-11 false true false 28400 91876 91876 0 false 1 0 0 0 false Palos Surgicenter, LLC /s/ Muhamad Amine Muhamad Amine President 2022-02-18