<PAGE>
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|EXPIRES: OCTOBER 31, 2001|
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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 15
CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER SECTION 12(g) OF
THE SECURITIES EXCHANGE ACT OF 1934 OR SUSPENSION OF DUTY TO FILE REPORTS UNDER
SECTIONS 13 AND 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934.
Commission File Number: 333-57191
EVEREST HEALTHCARE HOLDINGS, INC.*
ACUTE EXTRACORPOREAL SERVICES, L.L.C.
CON-MED SUPPLY COMPANY, INC.
CONTINENTAL HEALTH CARE, LTD.
DIALYSIS SPECIALISTS OF TULSA, INC.
DUPAGE DIALYSIS LTD.
EVEREST HEALTHCARE INDIANA, INC.
EVEREST HEALTHCARE OHIO, INC.
EVEREST HEALTHCARE TEXAS HOLDING CORP.
EVEREST HEALTHCARE TEXAS, L.P.
EVEREST MANAGEMENT, INC.
EVEREST NEW YORK HOLDINGS, INC.
EVEREST ONE IPA, INC.
EVEREST THREE IPA, INC.
EVEREST TWO IPA, INC.
HOME DIALYSIS OF AMERICA, INC.
MERCY DIALYSIS CENTER, INC.
NEW YORK DIALYSIS MANAGEMENT, INC.
NORTH BUCKNER DIALYSIS CENTER, INC.
NORTHERN NEW JERSEY DIALYSIS, L.L.C.
WSKC DIALYSIS SERVICES, INC.
(Exact name of registrant as specified in its charter)
101 North Scoville, Oak Park, Illinois 60302
(708) 386-1000
(Address, including zip code, and telephone number, including area code, of
registrant's principal executive offices)
Everest Healthcare Services Corporation 9 3/4% Senior Subordinated Notes Due
2008, Series B
Guarantees of Everest Healthcare Services Corporation 9 3/4% Senior
Subordinated Notes Due 2008, Series B
(Title of each class of securities covered by this Form)
NONE
(Titles of all other classes of securities for which a duty to file reports
under section 13(a) or 15(d) remains)
Please place an X in the box(es) to designate the appropriate rule
provision(s) relied upon to terminate or suspend the duty to file reports:
Rule 12g-4(a)(1)(i) / / Rule 12h-3(b)(1)(i) /X/
Rule 12g-4(a)(1)(ii) / / Rule 12h-3(b)(1)(ii) / /
Rule 12g-4(a)(2)(i) / / Rule 12h-3(b)(2)(i) / /
Rule 12g-4(a)(2)(ii) / / Rule 12h-3(b)(2)(ii) / /
Rule 15d-6 /X/
Approximate number of holders of record as of the certification or notice
date: ONE (1)
Pursuant to the requirements of the Securities Exchange Act of 1934, each
of the Registrants has caused this certification/notice to be signed on
its behalf by the undersigned duly authorized person.
Date: January 9, 2001 By: /s/ Steven A. Cohen
------------------------------
Name: Steven A. Cohen
Title: Authorized Person
____________________
* This Form 15 is filed in connection with the merger of Everest Healthcare
Services Corporation with and into Edmund Acquisition Sub, Inc., a wholly owned
subsidiary of Fresenius Medical Care AG, as more fully set forth in a Current
Report on Form 8-K filed on November 14, 2000 by each of the registrants. The
effective date of the merger was January 8, 2001, at which time the separate
existence of Everest Healthcare Services Corporation ceased, Edmund Acquisition
Sub, Inc. succeeded to all of the assets and liabilities of Everest Healthcare
Services Corporation, and Edmund Acquisition Sub, Inc. changed its name to
Everest Healthcare Holdings, Inc.
<PAGE>
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST HEALTHCARE
HOLDINGS, INC.
CENTRAL INDEX KEY: 0001058560
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY
OUTPATIENT FACILITIES, NEC [8093]
IRS NUMBER: 364045521
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191
FILM NUMBER: 796385
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
<PAGE>
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE HOLDINGS, INC. C/O EVEREST
HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: MERCY DIALYSIS CENTER INC
CENTRAL INDEX KEY: 0000825923
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 391589773
STATE OF INCORPORATION: WI
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-01
FILM NUMBER: 796386
BUSINESS ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
<PAGE>
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: CON MED SUPPLY CO INC
CENTRAL INDEX KEY: 0001064286
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 363147024
STATE OF INCORPORATION: IL
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 15-15D
<PAGE>
SEC ACT:
SEC FILE NUMBER: 333-05719-03
FILM NUMBER: 796387
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: CONTINENTAL HEALTH CARE LTD
CENTRAL INDEX KEY: 0001064287
STANDARD INDUSTRIAL CLASSIFICATION: []
<PAGE>
IRS NUMBER: 363084746
STATE OF INCORPORATION: IL
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-04
FILM NUMBER: 796388
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
<PAGE>
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: DUPAGE DIALYSIS LTD
CENTRAL INDEX KEY: 0001064290
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 363029873
STATE OF INCORPORATION: IL
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-07
FILM NUMBER: 796389
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
<PAGE>
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST MANAGEMENT INC
CENTRAL INDEX KEY: 0001064291
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 364338092
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-08
FILM NUMBER: 796390
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
<PAGE>
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: HOME DIALYSIS OF AMERICA INC
CENTRAL INDEX KEY: 0001064293
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 860711476
STATE OF INCORPORATION: AZ
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
<PAGE>
SEC FILE NUMBER: 333-57191-10
FILM NUMBER: 796391
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: NEW YORK DIALYSIS MANAGEMENT INC
CENTRAL INDEX KEY: 0001064296
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 363702390
<PAGE>
STATE OF INCORPORATION: NY
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-13
FILM NUMBER: 796392
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
<PAGE>
COMPANY DATA:
COMPANY CONFORMED NAME: NORTH BUCKNER DIALYSIS CENTER INC
CENTRAL INDEX KEY: 0001064297
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 364206319
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-14
FILM NUMBER: 796393
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
<PAGE>
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST HEALTHCARE INDIANA INC
CENTRAL INDEX KEY: 0001064300
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 363575844
STATE OF INCORPORATION: IN
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-16
FILM NUMBER: 796394
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
<PAGE>
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FORMER COMPANY:
FORMER CONFORMED NAME: OHIO VALLEY DIALYSIS CENTER INC
DATE OF NAME CHANGE: 19980617
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: WSKC DIALYSIS
SERVICES INC
CENTRAL INDEX KEY: 0001064302
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 362668594
STATE OF INCORPORATION: IL
FISCAL YEAR END: 0930
FILING VALUES:
<PAGE>
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-17
FILM NUMBER: 796395
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST NY
HOLDINGS INC
CENTRAL INDEX KEY: 0001064303
<PAGE>
STANDARD INDUSTRIAL CLASSIFICATION: []
STATE OF INCORPORATION: NY
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-18
FILM NUMBER: 796396
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
<PAGE>
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST ONE
IPA INC
CENTRAL INDEX KEY: 0001064305
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 133988854
STATE OF INCORPORATION: NY
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-19
FILM NUMBER: 796397
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
<PAGE>
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: ACUTE
EXTRACORPOREAL SERVICES LLC
CENTRAL INDEX KEY: 0001079481
STANDARD INDUSTRIAL CLASSIFICATION: []
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-20
FILM NUMBER: 796398
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
<PAGE>
ZIP: 60302
BUSINESS PHONE: 7083861000
MAIL ADDRESS:
STREET 1: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST TWO
IPA INC
CENTRAL INDEX KEY: 0001079488
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 364276710
STATE OF INCORPORATION: NY
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-21
FILM NUMBER: 796399
BUSINESS ADDRESS:
<PAGE>
STREET 1: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
MAIL ADDRESS:
STREET 1: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST THREE
IPA INC
CENTRAL INDEX KEY: 0001079489
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 365276711
STATE OF INCORPORATION: NY
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-22
<PAGE>
FILM NUMBER: 796400
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
MAIL ADDRESS:
STREET 1: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST
HEALTHCARE OHIO INC
CENTRAL INDEX KEY: 0001086149
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-
SPECIALTY OUTPATIENT FACILITIES, NEC [8093]
IRS NUMBER: 311418495
STATE OF INCORPORATION: OH
FISCAL YEAR END: 0930
FILING VALUES:
<PAGE>
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-24
FILM NUMBER: 796401
BUSINESS ADDRESS:
STREET 1: 101 N SCOVILLE
STREET 2: 708-386-2511
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 7083862511
MAIL ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FORMER COMPANY:
FORMER CONFORMED NAME: HOME DIALYSIS OF FAIRFIELD INC
DATE OF NAME CHANGE: 19990510
FILER:
<PAGE>
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST HEALTHCARE TEXAS LP
CENTRAL INDEX KEY: 0001101737
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 364321507
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-26
FILM NUMBER: 796402
BUSINESS ADDRESS:
STREET 1: C/O EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
MAIL ADDRESS:
STREET 1: C/O EVEREST HEALTHCARE SERVICES CORP
<PAGE>
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVEREST HEALTHCARE TEXAS
HOLDING CORP
CENTRAL INDEX KEY: 0001101738
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 364321504
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-27
FILM NUMBER: 796403
BUSINESS ADDRESS:
STREET 1: C/O EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
<PAGE>
CITY: OAK PARK
STATE: IL
ZIP: 60302
MAIL ADDRESS:
STREET 1: C/O EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 NORTH SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
<PAGE>
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: DIALYSIS SPECIALISTS OF TULSA INC
CENTRAL INDEX KEY: 0001102101
STANDARD INDUSTRIAL CLASSIFICATION:
IRS NUMBER: 731508212
STATE OF INCORPORATION: OK
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-28
FILM NUMBER: 764058
BUSINESS ADDRESS:
STREET 1: C/O EVEREST HEALTHCARE SERVICES CORP
STREET 2: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 70083861000
MAIL ADDRESS:
STREET 1: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
<PAGE>
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: NORTHERN NEW JERSEY DIALYSIS LLC
CENTRAL INDEX KEY: 0001102103
STANDARD INDUSTRIAL CLASSIFICATION: [ ]
IRS NUMBER: 364291598
STATE OF INCORPORATION: OK
FISCAL YEAR END: 0930
FILING VALUES:
FORM TYPE: 15-15D
SEC ACT:
SEC FILE NUMBER: 333-57191-29
FILM NUMBER: 764059
BUSINESS ADDRESS:
STREET 1: EVEREST HEALTHCARE SERVICES
STREET 2: 101 N SCOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
BUSINESS PHONE: 70083861000
MAIL ADDRESS:
STREET 1: 101 N SECOVILLE
CITY: OAK PARK
STATE: IL
ZIP: 60302
