| LCA CASE NUMBER | I-200-19297-107256 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2019-10-24 |
| DECISION DATE | 2019-10-31 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician (Family Medicine) |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-01-01 |
| END DATE | 2022-12-31 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | St. Vincent Medical Group |
| EMPLOYER ADDRESS1 | 250 W. 96th Street |
| EMPLOYER ADDRESS2 | Suite 520 |
| EMPLOYER CITY | INDIANAPOLIS |
| EMPLOYER STATE | IN |
| EMPLOYER POSTAL CODE | 46260 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | +13175834361 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Niccolini |
| EMPLOYER POC FIRST NAME | Neisha |
| EMPLOYER POC JOB TITLE | System Manager, Provider Contracting |
| EMPLOYER POC ADDRESS1 | 250 W. 96th Street |
| EMPLOYER POC ADDRESS2 | Suite 520 |
| EMPLOYER POC CITY | Indianapolis |
| EMPLOYER POC STATE | IN |
| EMPLOYER POC POSTAL CODE | 46260 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | +13175834361 |
| EMPLOYER POC EMAIL | Neisha.Niccolini@ascension.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Kim |
| AGENT ATTORNEY FIRST NAME | Michael |
| AGENT ATTORNEY MIDDLE NAME | Lee |
| 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 | 13179771418.0 |
| 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 | 1.0 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 188 E. Southway Boulevard |
| LCA CASE WORKLOC1 CITY | Kokomo |
| WORKSITE COUNTY | HOWARD |
| LCA CASE WORKLOC1 STATE | IN |
| WORKSITE POSTAL CODE | 46902 |
| LCA CASE WAGE RATE FROM | 187000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 170165.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 2.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
