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

MS. Dara Marie Wagner, APN-C

Individual provider Nurse Practitioner · NPI 1063046464

MS. Dara Marie Wagner, APN-C is a Nurse Practitioner in Canton, Illinois. Qualified in 2019, 7 years ago. Practices with Graham Hospital Association, a 123-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
7
Licensed in
IL
In the registry since
2020
Specialties on file
2

Practice location Address checks out

180 S Main St
Canton, IL 61520-2608
Phone: (309) 647-0201
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209020976 (IL)
Nurse Practitioner Taxonomy 363L00000X · Licence 209020976 (IL)

Record details

NPI number1063046464
Entity typeIndividual (Type 1)
GenderFemale
Credentials APN-C
Sole proprietorNo
NPI enumeratedFebruary 25, 2020
Last updated in NPPESOctober 20, 2021
Certification dateOctober 20, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Graham Hospital Association — 123 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Canton