| LCA CASE NUMBER | I-200-21015-015977 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-01-15 |
| DECISION DATE | 2021-01-25 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Hospitalist |
| SOC CODE | 29-1069.03 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| 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 | Katherine Shaw Bethea Hospital |
| EMPLOYER ADDRESS1 | 403 E. First Street |
| EMPLOYER CITY | Dixon |
| EMPLOYER STATE | IL |
| EMPLOYER POSTAL CODE | 61021 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18152855617 |
| NAICS CODE | 6221 |
| EMPLOYER POC LAST NAME | Ravlin |
| EMPLOYER POC FIRST NAME | Suzanne |
| EMPLOYER POC JOB TITLE | Vice President/Chief Legal Officer |
| EMPLOYER POC ADDRESS 1 | 403 E. First Street |
| EMPLOYER POC CITY | Dixon |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 61021 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18152855617 |
| EMPLOYER POC EMAIL | sravlin@ksbhospital.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Simon |
| AGENT ATTORNEY FIRST NAME | Kelly |
| AGENT ATTORNEY MIDDLE NAME | E. |
| AGENT ATTORNEY ADDRESS1 | One U.S. Bank Plaza |
| AGENT ATTORNEY ADDRESS2 | Ste. 2700 |
| AGENT ATTORNEY CITY | St. Louis |
| AGENT ATTORNEY STATE | MO |
| AGENT ATTORNEY POSTAL CODE | 63101 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13145526000 |
| AGENT ATTORNEY EMAIL ADDRESS | immigration@thompsoncoburn.com |
| LAWFIRM NAME BUSINESS NAME | THOMPSON COBURN LLP |
| STATE OF HIGHEST COURT | MO |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 403 E. First Street |
| LCA CASE WORKLOC1 CITY | Dixon |
| WORKSITE COUNTY | LEE |
| LCA CASE WORKLOC1 STATE | IL |
| WORKSITE POSTAL CODE | 61021 |
| LCA CASE WAGE RATE FROM | 208000 |
| LCA CASE WAGE RATE TO | 371425.6 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
