| LCA CASE NUMBER | I-200-21091-189523 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-01 |
| DECISION DATE | 2021-04-08 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Physician (Internal Medicine) |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| 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 | Ascension Medical Group - Northern Wisconsin, Inc. |
| EMPLOYER ADDRESS1 | 400 W. River Woods Parkway |
| EMPLOYER CITY | Glendale |
| EMPLOYER STATE | WI |
| EMPLOYER POSTAL CODE | 53212 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14144653797 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | O'Connell |
| EMPLOYER POC FIRST NAME | Lesley |
| EMPLOYER POC JOB TITLE | Director of Provider Recruitment |
| EMPLOYER POC ADDRESS 1 | 400 W. River Woods Parkway |
| EMPLOYER POC CITY | Glendale |
| EMPLOYER POC STATE | WI |
| EMPLOYER POC POSTAL CODE | 53212 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14144653797 |
| EMPLOYER POC EMAIL | Lesley.Oconnell@ascension.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 | True |
| SECONDARY ENTITY BUSINESS NAME | Ascension St. Michael's - Illinois Avenue |
| WORKSITE ADDRESS1 | 824 Illinois Avenue |
| LCA CASE WORKLOC1 CITY | Stevens Point |
| WORKSITE COUNTY | PORTAGE |
| LCA CASE WORKLOC1 STATE | WI |
| WORKSITE POSTAL CODE | 54481 |
| LCA CASE WAGE RATE FROM | 250000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 90563 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| 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 |
