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

Dr. Benjamin J Wagner, DO

Individual provider Emergency Medicine Physician · NPI 1497047567

Dr. Benjamin J Wagner, DO is an Emergency Medicine in Carbondale, Illinois. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2011, 15 years ago. Practices with Southern Illinois Medical Services Nfp, a 332-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois and Pennsylvania.

Years since qualifying
15
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
IL, PA
In the registry since
2011
Specialties on file
2
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.

See every abbreviation used in this directory →

Practice location Address checks out

405 W Jackson St
Carbondale, IL 62901-1462
Phone: (618) 549-0721
Fax: (618) 457-0469
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 201 S 14th St, Herrin, IL 62948-3631 — (618) 942-2171
  • 2 S Hospital Dr, Murphysboro, IL 62966-3333 — (618) 684-3156

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 036140784 (IL)
Emergency Medicine Physician Taxonomy 207P00000X · Licence OS016686 (PA)

Record details

NPI number1497047567
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 9, 2011
Last updated in NPPESFebruary 11, 2021
Certification dateFebruary 11, 2021
Mailing address1086 Franklin St, Johnstown, PA 15905-4305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2011 (15 years in practice)
Group practice Southern Illinois Medical Services Nfp — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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