Notification of Changes for Business Entity
General Information  
Business Entity Name: WILLIS OF ILLINOIS, INC
Incorporation / Formation Date:  
FEIN: 36-2691200
Ohio License Number:
NPN:
DBA / Trade Name:  
State of Domicile: IL
County: COOK
Business Address  
Address 1: WILLIS TOWER, 233 SOUTH WACKER DRIVE
Address 2:  
City: CHICAGO
State: IL
Zip: 60606
Phone: 6158723447
Fax:  
Business Web Site Address:  
Business Email Address:  
Mailing Address  
Address 1: WILLIS TOWER, 233 SOUTH WACKER DRIVE
Address 2:  
City: CHICAGO
State: IL
Zip: 60606
   
Indicate the type of change you are seeking
Address Change: NO
Business Entity Name Change: NO Old Business Entity Name:  
New DBA/Trade Name: NO New DBA/Trade Name:  
Amend DBA/Trade Name: NO Old DBA/Trade Name:  
Add/Delete Producers, Members, Owners, Partners, Officers and/or Directors: YES
   
Licensed Producers
Name Title NPN Add Delete Eff. Date
CHARIS A LEHNERT ASSOCIATE - BROKING 8910145 YES   12/11/2018
           
Members, Owners, Partners, Officers and Directors
Name Title Identifying # Add Delete Eff. Date
Title Business Entities Only
1. Is any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance? (i.e. banking, auto dealer, mortgage company)
2. Has any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance since the filing of the previous CN-65 or the original application?
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement  
Submitted By  
Submitted By: TRACIE HITE
Title: LICENSING COMPLIANCE ANALYST
Phone Number: 6158723447
Email Address: TRACIE.HITE@WILLISTOWERSWATSON.COM