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

Eric David Wagner

Individual provider Certified Registered Nurse Anesthetist · NPI 1306358445

Eric David Wagner is a Certified Registered Nurse Anesthetist (CRNA) in Carbondale, Illinois. Graduated from University of Michigan Medical School in 2017, 9 years ago. Practices with Northstar Anesthesia of Illinois, LLC, a 406-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
9
Trained at
University of Michigan Medical School
Licensed in
IL
In the registry since
2017
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Practice location Address checks out

405 W Jackson St
Carbondale, IL 62901-1462
Phone: (618) 549-0721
Fax: (618) 529-0449
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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

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 209016825 (IL)

Record details

NPI number1306358445
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 30, 2017
Last updated in NPPESMarch 5, 2021
Certification dateMarch 5, 2021
Mailing addressPo Box 3988, Carbondale, IL 62902-3988

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolUNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated 2017 (9 years in practice)
Group practice Northstar Anesthesia Of Illinois, Llc — 406 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Carbondale