| LCA CASE NUMBER | I-200-21104-224960 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-14 |
| DECISION DATE | 2021-04-21 |
| 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 | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-26 |
| END DATE | 2024-07-25 |
| 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 | Baldwin Area Medical Center |
| TRADE NAME DBA | Western Wisconsin Health |
| EMPLOYER ADDRESS1 | 1100 Bergslien St |
| EMPLOYER CITY | Baldwin |
| EMPLOYER STATE | WI |
| EMPLOYER POSTAL CODE | 54002 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17156841100 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Page |
| EMPLOYER POC FIRST NAME | Alison |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS 1 | 1100 Bergslien St |
| EMPLOYER POC CITY | Baldwin |
| EMPLOYER POC STATE | WI |
| EMPLOYER POC POSTAL CODE | 54002 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17156841100 |
| EMPLOYER POC EMAIL | alison.page@wwhealth.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Webster |
| AGENT ATTORNEY FIRST NAME | Matthew |
| AGENT ATTORNEY MIDDLE NAME | P. |
| AGENT ATTORNEY ADDRESS1 | 200 South 6th Street |
| AGENT ATTORNEY ADDRESS2 | Suite 4000 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16124927234 |
| AGENT ATTORNEY EMAIL ADDRESS | mwebster@fredlaw.com |
| LAWFIRM NAME BUSINESS NAME | Fredrikson & Byron PA |
|
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1100 Bergslien Street |
| LCA CASE WORKLOC1 CITY | Baldwin |
| WORKSITE COUNTY | ST CROIX |
| LCA CASE WORKLOC1 STATE | WI |
| WORKSITE POSTAL CODE | 54002 |
| LCA CASE WAGE RATE FROM | 257413 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 198474 |
| 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 | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
