Healthcare Provider Details

I. General information

NPI: 1508773532
Provider Name (Legal Business Name): RUBY JUNE SISLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 GREENWAY RD
MONONA WI
53716-2548
US

IV. Provider business mailing address

115 S HANCOCK ST APT 1
MADISON WI
53703-3450
US

V. Phone/Fax

Practice location:
  • Phone: 608-221-7677
  • Fax:
Mailing address:
  • Phone: 608-322-3615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9262-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: