# IAS ILLINOIS PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265118723
- **Authorized official:** JESSE BREEDLOVE CRNA (PRESIDENT)
- **Authorized official phone:** (850) 624-6138

## Contact information

- **Practice address:** 2525 KANEVILLE RD, GENEVA, IL 60134-2578
- **Practice address phone:** (630) 584-1400
- **Practice address fax:** (630) 584-1733
- **Mailing address:** PO BOX 7411347, CHICAGO, IL 60674-3447
- **Mailing address phone:** (888) 987-1489
- **Mailing address fax:** (224) 255-5813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/27/2023
- **Last updated:** 09/16/2026