Individual
CAMILA AYANNA LEAH HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1747 W ROOSEVELT RD, CHICAGO, IL 60608
(312) 355-2642
Mailing address
1747 W ROOSEVELT RD, CHICAGO, IL 60608
(312) 355-2642
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036.165615
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2020
Last updated
08/02/2023
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