2018-03-15T11:47:33-05:00 2017-04-30 390758449 Wipfli LLP 10000 Innovation Drive Suite 250 Milwaukee WI 532264837 990 2016-05-01 363572331 Northern Illinois Cancer Treatment Cente NORT 8152841111 327 IL Route 2 Dixon IL 61021 Cynthia Zander Treasurer 8152841111 2018-03-14 1 Stephanie Hamilton CPA P01233633 4144319300 2018-03-14 207.250.78.130 2018-03-14 13:14:43 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 112551657ADC8ECFF0A5B15769BADE1D3EFC5973 2016 2021-01-29 14:40:06Z Dirk Meminger 327 IL Route 2 Dixon IL 61021 2278224 0 X www.nicancer.com X 1988 IL To provide radiation treatment services to residents in the surrounding communities. 7 7 0 7 0 0 4565 381 2938778 2262284 8842 7480 14065 8079 2966250 2278224 16925 12375 0 0 0 0 0 0 0 3178687 2899396 3195612 2911771 -229362 -633547 9366389 8336385 543079 146622 8823310 8189763 To operate a cancer center which will encompass highly sophisticated & expensive diagnostic & treatment procedures in order to carry out cancer treatment & research. 0 0 2609752 12375 2262284 Provided high quality cancer treatment with the latest comprehensive cancer treatment technology in a welcoming, comfortable and friendly environment. 13,000 procedures were performed during the year. The center also provided $37,000 of charity care during the year to patients who meet certain criteria under its charity care policy. 2609752 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 0 1 1 0 0 1 1 0 1 0 1 0 0 0 IL X Cynthia Zander 8152841111 327 IL Route 2 Dixon IL 61021 Tom Gehlbach MD Board Member (Beg 8/16) 2.00 X 0 0 0 Colleen Henkel Board Member (Beg 4/17) 2.00 X 0 0 0 Osmann Khawaja MD board Member (Thru 2/17) 2.00 X 0 0 0 Thomas McGlone MD Board Member 2.00 X 0 0 0 Andy Moore Board Member (Beg 6/17) 2.00 X 0 0 0 Mark Schmelzel MD Board Member (Thru 6/17) 2.00 X 0 0 0 James Sarver Chairman (Thru 4/17) 4.00 X X 0 0 0 Dirk Meminger Chairman (Beg 4/17) 4.00 X X 0 0 0 Kevin Marx Secretary 4.00 X X 0 0 0 Cynthia Zander Treasurer 4.00 X X 0 0 0 Jon Berens Administrative Director 40.00 X 190417 0 72331 190417 0 72331 1 0 1 1 CGH Medical Center 100 East LeFevre Rd Sterling IL 61081 Leased Employees 1044120 Weatherby Locums 72 Hawkins Cir Wheaton IL 60189 Temporary Physician Services 331660 Varian Medical Systems 70140 Network Place Chicago IL 60673 Software Support Services 331353 3 381 381 Patient Treatment Revenue 621400 2262284 2262284 2262284 7480 7480 8079 8079 8079 2278224 2262284 0 15559 X 12375 12375 976569 713821 262748 1677 1677 28198 28198 512052 512052 91804 91804 9469 9469 60924 60924 464589 455193 9396 3156 3156 6853 6853 638100 638100 81850 81850 Medical Supplies 8838 8838 Dues and Subscriptions 7927 7927 Bad Debt 5933 5933 Credit Card Fees 1074 1074 383 383 2911771 2609752 302019 0 500 500 2435896 1799638 235485 393647 185576 151983 11115721 5525104 6108932 5590617 400000 400000 9366389 8336385 37136 44200 299477 0 206466 102422 543079 146622 X 8823310 8189763 8823310 8189763 9366389 8336385 -633547 0 X 0 1 X 1 0 X 1276 100 4027 4565 381 10349 3440538 3804531 3538009 2938778 2262284 15984140 8543 414 12035 14065 8079 43136 3450357 3805045 3554071 2957408 2270744 16037625 0 0 0 16037625 16853 8944 9779 8842 7480 51898 16853 8944 9779 8842 7480 51898 3467210 3813989 3563850 2966250 2278224 16089523 0.99680 0.99590 0.00320 0.00410 X 25115 25115 6663853 1774424 4889429 4318863 3650579 668284 107890 100101 7789 5590617 Due to CGH Medical Center 102422 102422 2278224 0 2278224 0 2278224 2911771 0 2911771 0 2911771 0 Home of Hope Cancer Wellness Centers 1637 PLOCK Rd Dixon IL 61021 010743626 501(c)(3) 12375 Donation to support the not-for-profit organization who provide support services to cancer patients. 1 0 0 0 0 0 0 0 0 0 0 Jon Berens Administrative Director 188917 0 1500 0 0 0 46768 0 25563 0 262748 0 0 0 Form 990, Part VII, Line 5 JON BERENS RECEIVED COMPENSATION FROM CGH MEDICAL CENTER, AN UNRELATED ORGANIZATION, FOR SERVICES AS EXECUTIVE DIRECTOR FOR NORTHERN ILLINOIS CANCER TREATMENT CENTER. COMPENSATION AND OTHER BENEFITS AMOUNTED TO $262,748 IN TOTAL FOR 2016. Form 990, Part VI, Section A, line 6 The corporation has TWO MEMBERS: CGH MEDICAL CENTER AND KATHERINE SHAW BETHEA HOSPITAL. Form 990, Part VI, Section A, line 7a THE GOVERNING BODY CONSISTS OF 7 DIRECTORS, 3 OF WHICH ARE CHOSEN BY THE BOARD OF DIRECTORS OF CGH MEDICAL CENTER AND 3 OF WHICH ARE CHOSEN BY THE board of directors of KATHERINE SHAW BETHEA HOSPITAL. The 7th director is elected by a majority vote of the total combined membership. Form 990, Part VI, Section B, line 11b A DRAFT COPY OF FORM 990 IS PROVIDED TO THE Executive DIRECTOR AND THE TREASURER OF THE BOARD TO REVIEW THE RETURN. IF THEY AGREE, THEY MAKE COPIES AVAILABLE TO ALL directors OF THE BOARD FOR REVIEW. THEY THEN LET THE RETURN PREPARER KNOW THAT THE RETURN IS READY TO BE filed with the IRS. Form 990, Part VI, Section B, line 12c Any possible conflict of interest on the part of a director shall be disclosed to the board. When any such interest becomes a matter of Board action, such Director shall not vote or use personal influence on the matter, and shall not be counted in the quorum for a meeting at which Board action is to be taken on the matter. The director may, however, briefly state a position on the matter, and answer pertinent questions of board members. The minutes of all actions taken on such matters shall clearly reflect that these requirements have been met.Any possible conflict of interest on the part of a director shall be disclosed to the board. When any such interest becomes a matter of Board action, such Director shall not vote or use personal influence on the matter, and shall not be counted in the quorum for a meeting at which Board action is to be taken on the matter. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and audited financial statements are available upon request. Form 990, Part IX, line 11g Purchased Services: Program service expenses 70,439. Management and general expenses 0. Fundraising expenses 0. Total expenses 70,439. Physician Contract Services: Program service expenses 441,613. Management and general expenses 0. Fundraising expenses 0. Total expenses 441,613.