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  5. INTERNAL MEDICINE GROUP, LLC

INTERNAL MEDICINE GROUP, LLC

Company Details

Entity Name: INTERNAL MEDICINE GROUP, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 29 May 2001
Business ALEI: 0682620
Annual report due: 31 Mar 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 1 TOWNE PARK PLAZA, NORWICH, CT, 06360, United States
Mailing address: ONE TOWNE PARK PLAZA, NORWICH, CT, United States, 06360
ZIP code: 06360
County: New London
Place of Formation: CONNECTICUT
E-Mail: NorwichMD@gmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
IMG LLC 401(K) PLAN 2019 061620616 2020-10-15 INTERNAL MEDICINE GROUP, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2018 061620616 2019-10-04 INTERNAL MEDICINE GROUP, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2019-10-04
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2017 061620616 2018-10-15 INTERNAL MEDICINE GROUP, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2016 061620616 2017-10-16 INTERNAL MEDICINE GROUP, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2015 061620616 2016-10-17 INTERNAL MEDICINE GROUP, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2014 061620616 2015-10-12 INTERNAL MEDICINE GROUP, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2013 061620616 2014-10-15 INTERNAL MEDICINE GROUP, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2014-10-15
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2012 061620616 2015-10-12 INTERNAL MEDICINE GROUP, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2011 061620616 2012-09-06 INTERNAL MEDICINE GROUP, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Plan administrator’s name and address
Administrator’s EIN 061620616
Plan administrator’s name INTERNAL MEDICINE GROUP, LLC
Plan administrator’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360
Administrator’s telephone number 8608870010

Signature of
Role Plan administrator
Date 2012-09-06
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-06
Name of individual signing HANNA KACKIELO
Valid signature Filed with authorized/valid electronic signature
IMG LLC 401(K) PLAN 2010 061620616 2011-10-19 INTERNAL MEDICINE GROUP, LLC 6
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 325410
Sponsor’s telephone number 8608870010
Plan sponsor’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360

Plan administrator’s name and address
Administrator’s EIN 061620616
Plan administrator’s name INTERNAL MEDICINE GROUP, LLC
Plan administrator’s address 1 TOWNE PARK PLAZA, NORWICH, CT, 06360
Administrator’s telephone number 8608870010

Signature of
Role Plan administrator
Date 2011-10-19
Name of individual signing DARIUSZ PIETRUCZUK
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
DARIUSZ PIETRUCZUK Agent 1 TOWNE PARK PLZ, NORWICH, CT, 06360, United States 1 TOWNE PARK PLZ, NORWICH, CT, 06360, United States +1 860-303-8722 darekpik@msn.com 9 BAILEY HTS, NORWICH, CT, 06360, United States

Officer

Name Role Business address Residence address
HANNA KACKIELO MD Officer ONE TOWNE PARK PLAZA, NORWICH, CT, 06360, United States 9 BAILEY HEIGHTS, NORWICH, CT, 06360, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012229601 2024-02-02 No data Annual Report Annual Report No data
BF-0011403353 2023-05-31 No data Annual Report Annual Report No data
BF-0010382301 2022-08-30 No data Annual Report Annual Report 2022
0007192368 2021-02-26 No data Annual Report Annual Report 2020
0007192363 2021-02-26 No data Annual Report Annual Report 2019
0007192327 2021-02-26 No data Annual Report Annual Report 2012
0007192371 2021-02-26 No data Annual Report Annual Report 2021
0007192329 2021-02-26 No data Annual Report Annual Report 2013
0007192339 2021-02-26 No data Annual Report Annual Report 2014
0007192355 2021-02-26 No data Annual Report Annual Report 2017

Related by officers

No related officers

Related by address

1 TOWNE PARK PLAZA, NORWICH, CT, 06360, United States

COOK COUNSELING PLLC

ONE TOWNE PARK PLAZA, NORWICH, CT, United States, 06360

TOWNE PARK MEDICAL REALTY, LLC

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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