| LCA CASE NUMBER | I-200-22193-347242 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2022-07-12 |
| DECISION DATE | 2022-07-19 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Chief Medical Officer |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-07-20 |
| END DATE | 2025-07-19 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | St. Mary’s Hospital, Decatur, of the Hospital Sisters of the Third Order of St. Francis |
| TRADE NAME DBA | HSHS St. Mary’s Hospital, Decatur |
| EMPLOYER ADDRESS1 | 1800 E. Lake Shore Drive |
| EMPLOYER CITY | Decatur |
| EMPLOYER STATE | IL |
| EMPLOYER POSTAL CODE | 62521 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12175446464 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Kulavic |
| EMPLOYER POC FIRST NAME | Lauren |
| EMPLOYER POC JOB TITLE | Director-Human Resources |
| EMPLOYER POC ADDRESS1 | 800 E. Carpenter Street |
| EMPLOYER POC CITY | Springfield |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 62769 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12175446464 |
| EMPLOYER POC EMAIL | Lauren.kulavic@hshs.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Fillenwarth |
| AGENT ATTORNEY FIRST NAME | Charlotte |
| AGENT ATTORNEY MIDDLE NAME | Marie |
| AGENT ATTORNEY ADDRESS1 | 500 North Meridian Street |
| AGENT ATTORNEY ADDRESS2 | Suite 400 |
| AGENT ATTORNEY CITY | Indianapolis |
| AGENT ATTORNEY STATE | IN |
| AGENT ATTORNEY POSTAL CODE | 46204 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13179771476 |
| AGENT ATTORNEY EMAIL ADDRESS | CFillenwarth@hallrender.com |
| LAWFIRM NAME BUSINESS NAME | Hall, Render, Killian, Heath & Lyman, P.C. |
| STATE OF HIGHEST COURT | IN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1800 E. Lakeshore Drive |
| LCA CASE WORKLOC1 CITY | Decatur |
| WORKSITE COUNTY | MACON |
| LCA CASE WORKLOC1 STATE | IL |
| WORKSITE POSTAL CODE | 62521 |
| LCA CASE WAGE RATE FROM | 335004.8 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 284398 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2022 - 6/30/2023 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
