| LCA CASE NUMBER | I-200-20225-765498 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-08-12 |
| DECISION DATE | 2020-08-19 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-09-10 |
| END DATE | 2023-09-09 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Pinckneyville Community Hospital District |
| TRADE NAME DBA | Pinckneyville Community Hospital |
| EMPLOYER ADDRESS1 | 5383 State Route 154 |
| EMPLOYER CITY | Pinckneyville |
| EMPLOYER STATE | IL |
| EMPLOYER POSTAL CODE | 62274 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16183575901 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Dauby |
| EMPLOYER POC FIRST NAME | Randall |
| EMPLOYER POC MIDDLE NAME | W. |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 5383 State Route 154 |
| EMPLOYER POC CITY | Pinckneyville |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 62274 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16183575901 |
| EMPLOYER POC EMAIL | rdauby@pvillehosp.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Keeney |
| AGENT ATTORNEY FIRST NAME | Melanie |
| AGENT ATTORNEY MIDDLE NAME | Gurley |
| AGENT ATTORNEY ADDRESS1 | 34 N Meramec Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 600 |
| AGENT ATTORNEY CITY | St. Louis |
| AGENT ATTORNEY STATE | MO |
| AGENT ATTORNEY POSTAL CODE | 63105 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13148803611.0 |
| AGENT ATTORNEY EMAIL ADDRESS | mkeeney@tuethkeeney.com |
| LAWFIRM NAME BUSINESS NAME | Tueth, Keeney, Cooper, Mohan & Jackstatd PC |
| STATE OF HIGHEST COURT | MO |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 5383 State Route 154 |
| LCA CASE WORKLOC1 CITY | Pinckneyville |
| WORKSITE COUNTY | PERRY |
| LCA CASE WORKLOC1 STATE | IL |
| WORKSITE POSTAL CODE | 62274 |
| LCA CASE WAGE RATE FROM | 240000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 154565.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Register |
| PREPARER FIRST NAME | Laura |
| PREPARER MIDDLE INITIAL | E |
| PREPARER BUSINESS NAME | Tueth, Keeney, Cooper, Mohan & Jackstatd PC |
| PREPARER EMAIL | lregister@tuethkeeney.com |
