Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Benjamin Louis Wagner, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1295586048

Benjamin Louis Wagner, DO is a Student in an Organized Health Care Education/Training Program in Peoria, Illinois. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1295586048
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 29, 2024
Last updated in NPPESMarch 29, 2024
Certification dateMarch 29, 2024
Mailing address530 Ne Glen Oak Ave, Peoria, IL 61637-0001

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