| LCA CASE NUMBER | I-200-22152-229933 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2022-06-01 |
| DECISION DATE | 2022-06-08 |
| 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 | 2022-08-01 |
| END DATE | 2025-07-31 |
| 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 | CRUSADERS CENTRAL CLINIC ASSOCIATION |
| EMPLOYER ADDRESS1 | 1200 WEST STATE STREET |
| EMPLOYER CITY | ROCKFORD |
| EMPLOYER STATE | IL |
| EMPLOYER POSTAL CODE | 61102 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18154901616 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | DAVENPORT |
| EMPLOYER POC FIRST NAME | PEGGYANNE |
| EMPLOYER POC JOB TITLE | CREDENTIALING & PRIVILEGING ADMINISTRATOR |
| EMPLOYER POC ADDRESS1 | 1200 WEST STATE STREET |
| EMPLOYER POC CITY | ROCKFORD |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 61102 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18154901616 |
| EMPLOYER POC EMAIL | PDavenport@crusaderhealth.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | PEDERSON |
| AGENT ATTORNEY FIRST NAME | JAN |
| AGENT ATTORNEY ADDRESS1 | 6931 ARLINGTON ROAD |
| AGENT ATTORNEY ADDRESS2 | SUITE 450 |
| AGENT ATTORNEY CITY | BETHESDA |
| AGENT ATTORNEY STATE | MD |
| AGENT ATTORNEY POSTAL CODE | 20814 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | MD |
| AGENT ATTORNEY PHONE | 12405830003 |
| AGENT ATTORNEY EMAIL ADDRESS | jan@wcslaw.com |
| LAWFIRM NAME BUSINESS NAME | WRIGHT, CONSTABLE & SKEEN, L.L.P. |
| STATE OF HIGHEST COURT | DC |
| NAME OF HIGHEST STATE COURT | SUPREME COURT OF THE UNITED STATES |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1100 BROADWAY, |
| LCA CASE WORKLOC1 CITY | ROCKFORD |
| WORKSITE COUNTY | WINNEBAGO |
| LCA CASE WORKLOC1 STATE | IL |
| WORKSITE POSTAL CODE | 61104 |
| LCA CASE WAGE RATE FROM | 225116.84 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 71656 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 7 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
