FORM 1023-EZ for DOUGLAS MEDICAL FOUNDATION
| Field | Data |
|---|---|
| EIN | 81-4531356 |
| Case Number | EO-2017123-000209 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | DOUGLAS MEDICAL FOUNDATION |
| Organization’s Mailing Address | 421 SOUTH OAK PARK AVENUE APT F1 |
| City | OAK PARK |
| State | IL |
| ZIP | 60302 |
| Accounting period End | 12 |
| Primary contact name | LOTANNA NKEMDILIM |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
LOTANNA NKEMDILIM
PRESIDENT
421 SOUTH OAK PARK AVE APT F1
OAK PARK IL 60302
Officer/Director/Trustee Two
AMANDA HUSICK
DIRECTOR
442 SOUTH GROVE AVE APT 205
OAK PARK IL 60302
Officer/Director/Trustee Three
UCHENNA UDEZE
DIRECTOR
911 WATTS CIRCLE
NASHVILLE TN 37209
Officer/Director/Trustee Four
UZOMA OBIDIKE
DIRECTOR
224 DOTY STREET
HAMMOND IN 46320
Officer/Director/Trustee Five
CHIBUZOR OKPALA
DIRECTOR
421 SOUTH OAK PARK AVE APT F1
OAK PARK IL 60302
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/28/2016 |
| Organization Incorporation State | IL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E60 - Health Support Services |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| Qualify For Exemption | No |
| Legislation influence | No |
| Compensation of Officer director trustee | No |
| Donation of funds | No |
| Conducting Activities Outside of United States | Yes |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | No |
| Disaster relief assistance | No |
| One Third Support Public | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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