| LCA CASE NUMBER | I-200-21153-362622 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-02 |
| DECISION DATE | 2021-06-09 |
| 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 | True |
| LCA CASE EMPLOYMENT START DATE | 2021-10-01 |
| END DATE | 2024-09-30 |
| 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 | La Porte Clinic Company, LLC |
| EMPLOYER ADDRESS1 | 1331 State Street |
| EMPLOYER CITY | La Porte |
| EMPLOYER STATE | IN |
| EMPLOYER POSTAL CODE | 46350 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12193262555 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Dickinson |
| EMPLOYER POC FIRST NAME | Ashley |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS 1 | 1331 State Street |
| EMPLOYER POC CITY | La Porte |
| EMPLOYER POC STATE | IN |
| EMPLOYER POC POSTAL CODE | 46350 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12193262555 |
| EMPLOYER POC EMAIL | a.dickinson@nwhealthin.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Taub |
| AGENT ATTORNEY FIRST NAME | Elissa |
| AGENT ATTORNEY ADDRESS1 | 1028 Oakhaven Rd |
| AGENT ATTORNEY CITY | Memphis |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 38119 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19016826455 |
| AGENT ATTORNEY EMAIL ADDRESS | etaub@visalaw.com |
| LAWFIRM NAME BUSINESS NAME | Siskind Susser PC |
| STATE OF HIGHEST COURT | FL |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 401 Newporte Blvd |
| LCA CASE WORKLOC1 CITY | La Porte |
| WORKSITE COUNTY | LA PORTE |
| LCA CASE WORKLOC1 STATE | IN |
| WORKSITE POSTAL CODE | 46350 |
| LCA CASE WAGE RATE FROM | 225000 |
| 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 |
| PREPARER LAST NAME | Schaffler |
| PREPARER FIRST NAME | Macrae |
| PREPARER BUSINESS NAME | Siskind Susser PC |
| PREPARER EMAIL | mschaffler@visalaw.com |
