Individual
DYLAN GABRIEL BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
15724 S ROUTE 59 STE 102, PLAINFIELD, IL 60544-2806
(630) 527-8877
(630) 527-8877
Mailing address
15724 S ROUTE 59 STE 102, PLAINFIELD, IL 60544-2806
(630) 527-8877
(630) 527-8877
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150113557
LSW
IL
Enumeration date
12/30/2022
Last updated
12/11/2025
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