| CASE NUMBER | I-200-24344-528361 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/9/2024 |
| DECISION DATE | 12/16/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Primary Care Physician |
| SOC CODE | 29-1216.00 |
| SOC TITLE | General Internal Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/27/2025 |
| END DATE | 1/26/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | PMR Illinois Holding, LLC |
| TRADE NAME DBA | JenCare Senior Medical Center |
| EMPLOYER ADDRESS1 | 1395 NW 167TH ST |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Miami Gardens |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 33169-5710 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | FL |
| EMPLOYER PHONE | 13056286130 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Chavez |
| EMPLOYER POC FIRST NAME | Amanda |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Immigration and Licensing Specialist |
| EMPLOYER POC ADDRESS1 | 1395 NW 167th Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Miami |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 33169 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17868971230 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | amanda.chavez@chenmed.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Webster |
| AGENT ATTORNEY FIRST NAME | Matthew |
| AGENT ATTORNEY MIDDLE NAME | P. |
| AGENT ATTORNEY ADDRESS1 | 60 South Sixth Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1500 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16124927234 |
| AGENT ATTORNEY PHONE EXT | |
| 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 | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 2231 E 95th Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Chicago |
| WORKSITE COUNTY | COOK |
| WORKSITE STATE | IL |
| WORKSITE POSTAL CODE | 60617 |
| WAGE RATE OF PAY FROM | $141,835.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $250,000.00 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $141,835.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-01-27 |
