Individual
DR. JESSI WIECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
735 INSIGHT AVE, O FALLON, IL 62269-2193
(618) 628-2903
Mailing address
735 INSIGHT AVE, O FALLON, IL 62269-2193
(618) 628-2903
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046012147
IL
152W00000X
Optometrist
137510
IA
152W00000X
Optometrist
2025018913
MO
Other
Enumeration date
05/20/2025
Last updated
08/11/2026
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