ELEVATEMED INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ELEVATEMED INC (EIN 83-3557457)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-06-02
- IRS object ID
- 202231539349301028
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-06-02T11:20:15-00:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 260658321 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AZ BUSINESS CONSULTING | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 702 | AddressLine1Txt |
| City | WADDELL | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85355 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 833557457 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELEVATEMED INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ELEV | BusinessNameControlTxt |
| Phone | 4802695774 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12622 N 56TH PLACE | AddressLine1Txt |
| City | SCOTTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85254 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR ALYX PORTER UMPHREY | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4802695774 | PhoneNum |
| Signature | 2022-05-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DR ALYX | PersonFirstNm |
| Person Last | PORTER UMPHREY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAWN BROWN | PreparerPersonNm |
| PTIN | P01228058 | PTIN |
| Phone | 6239771475 | PhoneNum |
| Preparation | 2022-05-26 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR ALYX PORTER UMPHREY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12622 N 56TH PLACE | AddressLine1Txt |
| City | SCOTTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $527,320 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ELEVATEMED.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2018 | FormationYr |
| Legal Domicile State | AZ | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE FINANCIAL ASSISTANCE AND MENTORING TO MEDICAL STUDENTS FROM RACIAL AND ETHNIC BACKGROUNDS TRADITIONALLY UNDERREPRESENTED IN MEDICINE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $342,364 | PYContributionsGrantsAmt |
| CY Contributions Grants | $471,908 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $18 | PYInvestmentIncomeAmt |
| CY Investment Income | $27 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$26,321 | PYOtherRevenueAmt |
| CY Other Revenue | -$9,562 | CYOtherRevenueAmt |
| PY Total Revenue | $316,061 | PYTotalRevenueAmt |
| CY Total Revenue | $462,373 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $100,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $225,350 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $2,000 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $27,707 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $53,085 | PYOtherExpensesAmt |
| CY Other Expenses | $69,047 | CYOtherExpensesAmt |
| PY Total Expenses | $153,085 | PYTotalExpensesAmt |
| CY Total Expenses | $296,397 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $162,976 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $165,976 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $359,901 | TotalAssetsBOYAmt |
| Total Assets EOY | $521,979 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,898 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $356,003 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $521,979 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE FINANCIAL ASSISTANCE AND MENTORING TO MEDICAL STUDENTS FROM RACIAL AND ETHNIC BACKGROUNDS TRADITIONALLY UNDERREPRESENTED IN MEDICINE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $244,606 | ExpenseAmt |
| Grant | $225,350 | GrantAmt |
| Desc | ELEVATEMED WAS DEVELOPED OUT OF THE NEED TO ELEVATE MEDICINE TO AN IDEAL WHERE THE PHYSICIAN WORKFORCE RACIALLY AND ETHNICALLY REPRESENTS THE COMMUNITY SERVED. WE INTEND TO ACHIEVE THIS BY PROVIDING SIGNIFICANT FINANCIAL ASSISTANCE TO MEDICAL STUDENTS WHILE PROVIDING THEM ACCESS TO MENTORSHIP, LEADERSHIP TRAINING, AND FINANCIAL MANAGEMENT EDUCATION. IN 2021 ELEVATEMED INC. GAVE OVER 225,000 IN SCHOLARSHIPS AND SUPPORT TO 20 MEDICAL STUDENTS FROM UNDERREPRESENTED BACKGROUNDS. WE HELD OUR FIRST ANNUAL SCHOLAR SUMMIT WHICH INCLUDED PERSONALIZED WORKSHOPS FOR THE MEDICAL STUDENTS REGARDING THEIR CAREER DEVELOPMENT. WE PROVIDED ONLINE RESOURCES AND DATA REGARDING HEALTH DISPARITIES IN THE UNITED STATES FOR OUR ONLINE COMMUNITIES. | Desc |
| Total Program Service Expenses | $244,606 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (true) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Excs Tax Sect4951 Or4952 Or4953 | false | ExcsTaxSect4951Or4952Or4953Ind |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Policies Reference Chapters | Yes (true) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICK BROOKS CPA | PersonNm |
| Phone | 4802695774 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12622 N 56TH PLACE | AddressLine1Txt |
| City | SCOTTSDALE | CityNm |
| State Abbreviation | AZ | StateAbbreviationCd |
| ZIP | 85254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| ALYX PORTER UMPHREY MD FAAN | ||||||
| EXEC DIRECTOR | 008.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GREG UMPHREY MD | ||||||
| BOARD CHAIR | 002.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARISSA VASQUEZ MD MBA | ||||||
| BOARD VICE CHAIR | 002.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PATRICK BROOKS CPA | ||||||
| TREASURER | 002.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TIFFANY HARDAWAY MD MS | ||||||
| SECRETARY | 002.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BERT VARGAS MD FAHS FAAN | ||||||
| DIRECTOR | 001.00 | Yes (X) | $0 | $0 | $0 | |
| SHANNON SMITH MD FAAPMR | ||||||
| DIRECTOR | 001.00 | Yes (X) | $0 | $0 | $0 | |
| ANDREW SANDERSON MD MPH FASGE | ||||||
| DIRECTOR | 001.00 | Yes (X) | $0 | $0 | $0 | |
| GYASI CHISLEY PMP FACHE | ||||||
| DIRECTOR | 001.00 | Yes (X) | $0 | $0 | $0 | |
| RICARDO CORREA MD ESD FACP FACE CMQ | ||||||
| DIRECTOR | 001.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Fundraising | $151,897 | FundraisingAmt |
| All Other Contributions | $320,011 | AllOtherContributionsAmt |
| Noncash Contributions | $5,705 | NoncashContributionsAmt |
| Total Contributions | $471,908 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27 | TotalRevenueColumnAmt |
| Exclusion | $27 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $54,955 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $151,897 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $64,947 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$9,992 | TotalRevenueColumnAmt |
| Exclusion | -$9,992 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $430 | GrossSalesOfInventoryAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $430 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $462,373 | TotalRevenueColumnAmt |
| Exclusion | -$9,965 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,350 | TotalAmt |
| Program Services | $225,350 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Management And General | $10,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Fundraising | $2,000 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,412 | TotalAmt |
| Program Services | $12,564 | ProgramServicesAmt |
| Management And General | $5,141 | ManagementAndGeneralAmt |
| Fundraising | $25,707 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,500 | TotalAmt |
| Program Services | $1,500 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,875 | TotalAmt |
| Program Services | $205 | ProgramServicesAmt |
| Management And General | $7,670 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,508 | TotalAmt |
| Program Services | $235 | ProgramServicesAmt |
| Management And General | $1,273 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,500 | TotalAmt |
| Program Services | $4,500 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $252 | TotalAmt |
| Program Services | $252 | ProgramServicesAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,397 | TotalAmt |
| Program Services | $244,606 | ProgramServicesAmt |
| Management And General | $24,084 | ManagementAndGeneralAmt |
| Fundraising | $27,707 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,315 | BOYAmt |
| EOY | $235,949 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,086 | BOYAmt |
| EOY | $226,561 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $57,882 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,500 | BOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,337 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $250 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,901 | BOYAmt |
| EOY | $521,979 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,898 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,898 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $356,003 | BOYAmt |
| EOY | $521,979 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $356,003 | BOYAmt |
| EOY | $521,979 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,901 | BOYAmt |
| EOY | $521,979 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $165,976 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $2,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $226,733 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $392,364 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $471,909 | CurrentTaxYearAmt |
| Total | $1,093,506 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $2,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $226,733 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $392,364 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $471,909 | CurrentTaxYearAmt |
| Total | $1,093,506 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $181,459 | SubstantialContributorsTotAmt |
| Public Support Total170 | $912,047 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $12 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27 | CurrentTaxYearAmt |
| Total | $57 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,093,563 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $8,580 | GrossReceiptsRltdActivitiesAmt |
| First5 Years170 | Yes (X) | First5Years170Ind |
| Public Support CY170 | 0.00000 | PublicSupportCY170Pct |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (true) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIFFANY WILLIAMS | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1515 S MICHIGAN AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60605 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | FUNDRAISING | ActivityTxt |
| Fundraiser Control Of Funds | false | FundraiserControlOfFundsInd |
| Retained By Contractor | $2,000 | RetainedByContractorAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $2,000 | TotalRetainedByContractorsAmt |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $206,852 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $151,897 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $54,955 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $8,411 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $7,133 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $10,760 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $2,275 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $36,368 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $206,852 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $151,897 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $54,955 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $8,411 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $7,133 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $10,760 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $2,275 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $36,368 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $64,947 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$9,992 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS AND MENTORSHIP | GrantTypeTxt |
| Recipient | 20 | RecipientCnt |
| Cash Grant | $225,350 | CashGrantAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I Line 2 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATIOIN ONLY PROVIDES ASSISTANCE TO MEDICAL STUDENTS ENROLLED IN AN ACCREDITED US MEDICAL SCHOOLS. SCHOLARSHIPS ARE REMITTED DIRECTLY TO THE STUDENTS INSTITUTION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, Line 2 | DR ALYX PORTER UMPHREY AND DR GREG UMPHREY ARE RELATED BY MARRIAGE |
| Form 990, Part VI, Section B, Line 11B | THE TREASURER OF THE ORGANIZATION DISTRIBUTES A PDF COPY OF THE 990 TO ALL BOARD MEMBERS FOR REVIEW AND COMMENT PRIOR TO THE RETURN BEING FILED. |
| Form 990, Part VI, Section B, Line 12C | AT EACH BOARD AND COMMITTEE MEETING, IF THERE IS A DISCUSSION OF SELECTING OR ENGAGING A VENDOR OR SERVICE PROVIDER, ALL IN ATTENDANCE ARE ASKED TO RECUSE THEMSELVES FROM THIS DISCUSSION IF THERE COULD BE A PERCEIVED CONFLICT. ANNUALLY, THE ORGANIZATION REVIEWS AND DISCUSSES THE CONFLICT OF INTEREST POLICY AND REQUESTS THAT EACH BOARD MEMBER LIST AND ACKNOWLEDGE ANY KNOWN CONFLICTS. |
| Form 990, Part VI, Section B, Line 15 | THE EXECUTIVE COMMITEE REVIEWS THE COMPENSATION FOR ALL OFFICERS AND KEY EMPLOYEES BY COMPARING THEIR COMPENSATION TO THE COMPENSATION OF INDIVIDUALS IN LIKE POSITIONS IN COMPARABLE ORGANIZATIONS USING FORMS 990, COMPENSATION STUDIES, AND OTHER AVAILABLE DATA. THE COMMITTEE THEN APPROVES ANY CHANGES IN COMPENSATION BASED ON THIS INFORMATION. |
| Form 990, Part VI, Section C, Line 19 | THE ORGANIZATION WILL PROVIDE IN A TIMELY MANNER, COPIES OF ALL GOVERNING DOCUMENTS INCLUDING ITS CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS WHEN REQUESTED IN WRITING OR IN PERSON. |
| Form 990, Part IX, Line 11G | OTHER PROFESSIONAL FEES INCLUDES AMOUNTS PAID FOR ADMINISTRATIVE SUPPORT, PHOTOGRAPHY AND VIDEOGRAPHY, PUBLIC RELATIONS, AND WEBITE AND MARKETING CONSULTANTS. |
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