Provider Demographics
NPI:1437646163
Name:DIN, MEKSON H
Entity Type:Individual
Prefix:MR
First Name:MEKSON
Middle Name:H
Last Name:DIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:868 HEARTLAND PARK LN
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:IL
Mailing Address - Zip Code:60002-6220
Mailing Address - Country:US
Mailing Address - Phone:847-293-1865
Mailing Address - Fax:
Practice Address - Street 1:868 HEARTLAND PARK LN
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-6220
Practice Address - Country:US
Practice Address - Phone:847-293-1865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILD500-5485-8090347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker