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  5. Itasca Surgical Clinic, P.A.

Itasca Surgical Clinic, P.A.

Company Details

Name: Itasca Surgical Clinic, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 04 Dec 2001 (23 years ago)
Company Number: f00575cf-abd4-e011-a886-001ec94ffe7f
File Number: 11X-207
Registered Office Address: 1542 Golf Course Rd #202, Grand Rapids, MN 55744, USA
Principal Executive Office Address: 520 NW 1ST AVE, GRAND RAPIDS, MN 55744–2776, USA
ZIP code: 55744
County: Itasca County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2021 412022542 2022-10-10 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2183277973
Plan sponsor’s address 520 NW 1ST AVENUE, SUITE 5, GRAND RAPIDS, MN, 55744
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2020 412022542 2021-10-14 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2183277973
Plan sponsor’s address 520 NW 1ST AVENUE, SUITE 5, GRAND RAPIDS, MN, 55744
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2019 412022542 2020-07-30 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2183277973
Plan sponsor’s address 520 NW 1ST AVENUE, SUITE 5, GRAND RAPIDS, MN, 55744
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2018 412022542 2019-10-15 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2183277973
Plan sponsor’s address 520 NW 1ST AVENUE, SUITE 5, GRAND RAPIDS, MN, 55744
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2017 412022542 2018-10-15 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2183277973
Plan sponsor’s address 520 NW 1ST AVENUE, SUITE 5, GRAND RAPIDS, MN, 55744
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2016 412022542 2017-07-31 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2183277973
Plan sponsor’s address 1542 GOLF COURSE ROAD #202, GRAND RAPIDS, MN, 55744
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2015 412022542 2016-09-20 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621493
Sponsor’s telephone number 2183277973
Plan sponsor’s address 1542 GOLF COURSE ROAD #202, GRAND RAPIDS, MN, 55744
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2014 412022542 2015-10-02 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621493
Sponsor’s telephone number 2183277973
Plan sponsor’s address 1542 GOLF COURSE ROAD #202, GRAND RAPIDS, MN, 55744

Signature of
Role Plan administrator
Date 2015-10-02
Name of individual signing DANIEL J. MARGO
Valid signature Filed with authorized/valid electronic signature
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2013 412022542 2014-08-08 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621493
Sponsor’s telephone number 2183277973
Plan sponsor’s address 1542 GOLF COURSE ROAD #202, GRAND RAPIDS, MN, 55744

Signature of
Role Plan administrator
Date 2014-08-08
Name of individual signing DANIEL J. MARGO
Valid signature Filed with authorized/valid electronic signature
ITASCA SURGICAL CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2012 412022542 2013-09-27 ITASCA SURGICAL CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621493
Sponsor’s telephone number 2183277973
Plan sponsor’s address 1542 GOLF COURSE ROAD #202, GRAND RAPIDS, MN, 55744

Signature of
Role Plan administrator
Date 2013-09-27
Name of individual signing DANIEL J. MARGO
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Daniel Margo Chief Executive Officer 520 NW 1ST AVE, GRAND RAPIDS, MN 55744–2776, USA

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Domestic) 2007-04-23
Original Filing - Business Corporation (Domestic) 2001-12-04
Business Corporation (Domestic) Business Name (Business Name: Itasca Surgical Clinic, P.A.) 2001-12-04

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Date of last update: 26 Sep 2024

Sources: Minnesota's Official State Website

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